An algorithm for the diagnosis of sacrococcygeal pilonidal disease in resource-limited settings

Abstract

Pilonidal disease (PD) is a very common condition. In the countries of the global West, which have high per capita income and advanced health care systems, the average lifetime incidence is about 26 cases per 100,000 people. In the USA, about 70,000 new cases of the disease are registered annually. The full‑scale aggression of the Russian Federation in February 2022 resulted in a drastic decline in access to high‑quality health care in Ukraine, particularly affecting people living in temporarily occupied territories, communities with significant destruction, and internally displaced persons. Pilonidal disease substantially reduces patients’ working capacity, diminishes their quality of life, and, in some cases, can result in severe complications that pose an immediate threat to their lives.

Objective —  to develop a standardised algorithm for diagnosing sacrococcygeal pilonidal sinus disease (PD) in resource‑limited settings (combat zones, territories located in the close vicinity of the theatre of military operations where the population does not have full access to specialised health services; de‑occupied territories, which are temporarily deprived of access to qualified medical personnel and appropriate technical resources).

A standardised algorithm for diagnosing PD has been developed. It consists of nine stages organised into consecutive blocks. Each stage is designed according to the «task‑step‑commentary» principle and includes detailed explanations for performing the diagnostic procedure.

Conclusions. Sacrococcygeal pilonidal sinus disease is a common condition that requires timely diagnosis and further management. In resource‑limited settings, the creation of diagnostic algorithms is one of the important ways to improve access to health services.