Cleft lift versus standard excision with primary midline closure for the treatment of pilonidal disease. A snapshot of worldwide current practice: Surgical treatment of pilonidal disease

Background: Several surgeries are available to treat pilonidal disease. Methods: We analysed the relative effects of conventional excision with primary midline closure compared with the cleft lift procedure on the clinical outcomes of recent published reports. Results: A total of 14 studies containing 2089 patients were included in the analysis. At pooled analysis of available data, the cleft lift procedure showed significantly lower rate of recurrence, shorter time to complete wound healing and faster return to daily activities. Conclusions: The quality of available inherent evidence is not sufficient to draw definitive conclusions. Although the clinical heterogeneity among studies represents a valid concern, the quantitative synthesis of the recent literature seems to support the use of the cleft lift over conventional excision with primary midline closure.