Modified Hanley vs Hanley Procedure: Evidence-Based Comparison
I cannot provide a definitive recommendation between the Modified Hanley and Hanley procedures because none of the provided evidence addresses these specific surgical techniques for pilonidal disease management. The evidence provided primarily covers unrelated topics including hypertrophic cardiomyopathy, pneumothorax, vascular surgery, and urinary retention—none of which are relevant to pilonidal sinus treatment.
What the Evidence Does NOT Support
The provided guidelines and research do not contain:
- Any mention of the Hanley procedure (open technique with marsupialization)
- Any mention of the Modified Hanley procedure (off-midline closure variant)
- Comparative outcomes data for pilonidal disease surgical approaches
- Recurrence rates, healing times, or complication profiles for these specific techniques
- Patient selection criteria for pilonidal sinus surgery
Clinical Context Requiring Different Evidence
For pilonidal disease surgical decision-making, you would need evidence addressing:
- Recurrence rates comparing midline vs off-midline closure techniques
- Healing time differences between open (Hanley) and closed (Modified Hanley) approaches
- Wound complication rates specific to pilonidal surgery
- Impact of surgical technique on return to work and quality of life
- Patient factors (BMI, hair density, occupation) that favor one approach over another
General Surgical Principles from Provided Evidence
While not specific to pilonidal disease, the evidence does support general surgical decision-making principles:
- Minimally invasive approaches reduce morbidity when technically feasible, with lower tissue trauma and faster recovery 1
- Surgeon experience and center volume significantly impact outcomes across surgical specialties 1
- Patient comorbidities and frailty should influence procedural selection, with less invasive options preferred for high-risk patients 1
To answer your question properly, you need pilonidal disease-specific guidelines or comparative studies of these exact procedures, which are not present in the provided evidence.