ABSTRACT
Background:Pilonidal sinus is a common disease in young adults that carries high postoperative
morbidity and patients′ discomfort; controversy still exists regarding the best surgical
technique for the treatment of the disease. We successfully treat it with a rotation
flap technique (simple rotation and bilobed rotation flap).Materials and Methods: Sixty-two patients were randomized to receive surgical treatment in the form of either
simple rotation or bilobed rotation flap by eccentric elliptical excision of the diseased
tissues down to the sacral fascia and closure of the defect with the flap, then placing
a closed suction drain at the base of the wound, with its tip being brought out in
the gluteal region at least 5 cm laterally to the lower end of the suture. Results: All our patients healed completely without recurrence after a mean follow-up of about
one year. Mean hospital stay 1.5 days (range 1-3) Mean time to complete healing 11.9
days (range 8-14). Mean time off work was 11.5 days (range 10-21), wound infection
and breakdown, three (4.8%), recurrence (0%), and time to sitting on the toilet and
walking without pain was 10-15 days.Conclusions: A tension-free suture and cleft left via the rotation flap, either the bilobed flap
or monolobed, is the key to success without recurrence and low patient discomfort.
KEY WORDS
Bilobed fl ap - pilonidal - rotation
