Bascom's operation in the day-surgical management of symptomatic pilonidal sinus

Many treatments for symptomatic pilonidal sinus disease have been described. Ambulatory treatment with minimal morbidity and a rapid return to normal activity is desirable. Bascom's operation fulfils these requirements. This paper describes the operative technique and results of treatment.

Some 218 patients of mean age 27 years were treated as day cases. The mean duration of symptoms was 2.4 years. Sixty-eight per cent of patients had complex disease with more than two midline pits and/or a lateral discharging sinus. One hundred and eighty-three patients (84 per cent) were operated on under local anaesthesia.

Ninety-five per cent of patients have been followed up for a mean of 12.1 (range 1-60) months. All except one midline wound healed. Lateral wounds healed after a mean of 4.0 (range 1-15) weeks. Postoperative complications were few, including bleeding in 4 per cent and abscess formation treated by reopening the lateral incision in 6 per cent. Twenty-one patients (10 per cent) have had recurrence and have needed reoperation.

Bascom's operation is simple and results in considerable financial savings with minimal social disruption and an early return to work. Recurrent disease is no more frequent than after other treatments.