A new flap technique to treat pilonidal sinus

Failures of flap rotation, flap necrosis, recurrence of the disease, maceration at the incisional line and insufficient or late healing of flap corners which can be associated with ischemia appear to be the main problems associated with the closing techniques during the surgical treatment of this disease. We describe a simple, effective and incision protective repair method for excision of the pilonidal cyst.

Data from 17 (12 males and 5 females) consecutive patients who had elective surgery for chronic pilonidal sinus disease with wide excision of all the sinuses and a new flap technique closure with adipo-fascio-cutaneous flaps which was used in our series for the treatment of pilonidal sinus disease were retrospectively analyzed.

Satisfactory results were achieved with this flap rotation technique in 17 patients. There were no flap rotation failures, flap necrosis, disease recurrence, incisional line maceration, or delayed wound healing.

As a result, presented technique provides avoidance of flap necrosis, maceration on the incision and insufficient or late healing of the flap. We describe a technique which has a minimal amount of scar across the midline natal cleft and fewer flap corners resulting in a lower chance of margin necrosis.