The modified gluteal sliding plication closure in the treatment of chronic pilonidal sinus.

BACKGROUND: The surgical approach to pilonidal sinus disease is open to debate with no ideal treatment. The aim of this work is to present the efficacy of the modified gluteal sliding plication closure technique in treatment of pilonidal sinus disease as regards the complication and recurrence rates, while maintaining a more cosmetically acceptable midline scar. PATIENTS AND METHODS: All patients between the year 2000 and 2008 with symptomatic pilonidal disease were treated by the modified gluteal sliding plication closure method, except for recurrent cases after previous flap surgery. Outcome measures included wound complications, recurrence rate, follow-up period, and functional recovery. Patient esthetic satisfaction rates as regards the scar and shape of the buttocks were included on a scale of good, fair, or bad.
RESULTS: Fifty-six patients, 41 male and 15 females, with 23 years median age (range, 17-45 years) were treated. After a median follow-up period of 12 months (range, 6-84 months), the incidence of recurrence was 1.8%, infection rate of 10.7%, paresthesia and seroma accumulation in 3.6% of cases. The median functional recovery achieved was 12 days (range, 10-45 days), while the esthetic satisfaction rates were good in 78.57%, fair in 17.86% and bad in 3.5% of cases.
CONCLUSION: This study presents a successful modified technique of primary closure which allows an extensive en bloc removal of diseased tissues and permits a safe and complete primary closure without undue tension and with respect of cosmetic principles.