Awad et al developed a score that can be used to evaluate a patient with a pilonidal sinus. This can help select the optimum management strategy for the patient. The authors are from Zagazig University in Egypt.
Parameters:
(1) type of body hair
(2) body weight
(3) gender
(4) number of sinus openings
(5) site of the pilonidal sinus
(6) size of the lesion in cm
(7) primary vs recurrent
(8) duration in months
|
Parameter |
Finding |
Points |
|---|---|---|
|
type of body hair |
hair that is faint or fine |
1 |
|
|
hair that is hard and coarse |
2 |
|
body weight |
not overweight |
1 |
|
|
overweight |
2 |
|
gender |
female |
1 |
|
|
male |
2 |
|
number of sinus openings |
1 |
1 |
|
|
2 or more |
2 |
|
site |
midline |
1 |
|
|
not midline (at the convex side) |
2 |
|
size of the sinus in cm |
<= 0.5 cm |
2 |
|
|
> 0.5 cm |
1 |
|
primary vs recurrent |
primary |
1 |
|
|
recurrent |
2 |
|
duration |
< 6 months |
1 |
|
|
>= 6 months |
2 |
where:
• Scoring with 0 or 1 would seem to be more straightforward.
• An assumption is that the sinus measurement is the size of the skin opening. A pilonidal sinus that is deep or surrounded by fibrous tissue would be hard to measure. A larger sinus opening is less likely to become occluded and may be closer to the skin surface.
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 8
• maximum score: 16
|
Score |
Type |
Closure after Local Excision |
|---|---|---|
|
8 to 10 |
A |
none (healing by secondary intention) |
|
11 to 13 |
B |
primary closure |
|
14 to 16 |
C |
unilateral or bilateral rotation flaps |
Purpose: To evaluate a patient with a pilonidal sinus using the score of Awad et al.
Specialty: Dermatology, Surgery, general
Objective: clinical diagnosis, including family history for genetics, severity, prognosis, stage
ICD-10: L05,
