Pilonidal disease--a surgical enigma.

A retrospective review of 72 patients with pilonidal disease was conducted in order to examine current methods of treatment and establish certain guiding principles for success. The criteria for diagnosis included a pit of variable depth lined by epithelium or granulation tissue containing hair or from which hair had been extracted. A study of these patients suggested the possibility of a dual etiology for pilonidal disease, either congenital or acquired, acting singly or in combination. Management will be influenced by the surgeon's concept of origin in each case. These 72 patients who underwent a total of 116 operations were divided into two groups: (1) unifected sinuses and cysts, (2) infected and recurring cysts. The results of various operative procedures in both these groups indicate a higher probability of success when wide excision and open healing is employed.