Repeat pilonidal operations

Radical excision of pilonidal disease is unwarranted. The unhealed wound which may follow such surgery can be salvaged by the technique of cleft closure. Should repeat operation become necessary, the technique of cleft closure should be performed. It is simple, causes little disability, results in primary wound healing, and requires minimal postoperative care. The operation is directed against the cause of both pilonidal disease and the unhealed wound, which appears to be skin pulling away from bone, and not against the abscess in fat, which is a secondary effect.