Crossed triangular flaps technique for surgical treatment of chronic pilonidal sinus disease

Hypothesis: Pilonidal disease is a common chronic disorder of the sacrococcygeal region affecting young people. Although many surgical methods have been suggested, an ideal method is still lacking because of significant morbidity and high recurrence rates. However, the crossed triangular flaps technique, which involves excision and primary closure, with less morbidity and low recurrence rates, appears to meet the criteria for an ideal method. Design: Case series. Setting: This study was conducted in the General Surgery Department, Faculty of Medicine, Zagazig University, Zagazig City, Egypt, from January 2003 to November 2004. Patients: This study included 57 patients with chronic pilonidal sinus disease with a mean age of 29 years. Intervention: Limited and good excision of all diseased tissues was achieved, followed by a zigzag incision to produce triangular flaps on both sides of the wound. Multiple crossed triangular flaps were used to close the wound with a drain. The follow-up period ranged from 18 to 36 months (mean, 30 months). Main Outcome Measures: Length of hospital stay and return to normal activities, early wound complications, and recurrence. Results: The hospital stay for all patients was 24 hours and the mean time to return to work was 9 days (range, 7-12 days). Three cases (5.3\%) had early wound complications and 1 case (1.75\%) had recurrence. Conclusion: The crossed triangular flaps technique for pilonidal disease is simple and easy and has favorable results regarding time to return to work, rate of recurrence, and cosmetically acceptable postoperative appearance.