Sticking to the Facts: a Systematic Review of Fibrin Glue for Pilonidal Disease

Background: Pilonidal disease occurs when hair invading the natal cleft causes inflammation and abscess formation. Opinions vary on best practice, and most procedures have considerable morbidity and high recurrence rates of 6-40%.

Objectives: This study systematically reviews the use of fibrin glue in the treatment of pilonidal disease. Outcomes measured were healing time and recurrence rate.

Data Source: ScienceDirect and PubMed databases were searched for relevant literature, yielding seven papers including five small trials. The total number of patients receiving fibrin glue treatments across all trials was 85. There were no exclusion criteria in this review.

Results: Fibrin glue treatments had equivalent or better reported healing times than conventional therapies at an average of 2-6 weeks, and low recurrence rates between 0 and 17% at follow-up periods between 4 and 28 months. Considerable heterogeneity in study methodologies and surgical techniques prevented statistical significance or aggregate figures from being determined.

Conclusions: There appears to be early promise for the use of fibrin glue in the treatment of pilonidal disease and an impetus for definitive research.