A new surgical method of pilonidal sinus treatment: a bilaterally paralel elliptic fascio-cutaneous advancement flap technique.

Objective: Pilonidal sinus disease (PSD) is a common chronic disease in young people, It is often associated with considerable discomfort and morbidity.

Background: We aimed to describe our new bilateral parallel elliptic fascio-cutaneous advancement flap technique in PSD treatment and we assessed the technique's results in 57 patients.

Method: This procedure consists of a bilateral parallel elliptical excision, mobilization of the fascio-cutaneous flap from the median line of the wound, fixation of the base of the flap to the sacrococcygeal fascia by method of overlapping, and suturing its edge to the lateral side. Finally, we closed the wound without tension in accord with the anatomical plane.

Result: The mean age of the patients was 25.3 ± 4 years. Complications such as infection, wound dehiscence, and seroma were detected in 2 (3.5 %), 2 (3.5 %), and 3 (5.2 %) patients, respectively. The mean durations of hospitalization and absence from work were 2.4 ± 3 and 12.6 ± 3 days, respectively. The mean length of defects after operations was 14.4 ± 1 cm and the mean width was 7.2 ± 1 cm). Follow up period averaged 21.4 ± 1.2 (range, 12 to 72) months. Recurrence occurred in one (1.7 %) patient. included in this study. We detected a mild-degree wound dehiscence in patients with wound infection (n=2, 3.5 %).

Conclusion: Our novel technique provided the patients with minimum postoperative morbidity, short hospital stay and reduced absence from work. In addition, the technique has a satisfying aesthetic outcome and a decreased recurrence rate. Moreover, the flap could be prepared easily. In the light of our results, we suggest that our novel surgical technique seems to be a reasonable method in treatment of PSD (Fig. 2, Ref. 24).