The evolution of management of pilonidal sinus disease.

Pilonidal sinus disease has for too long been treated by radical methods, probably on the assumption that these were the only ways to prevent recurrence. A review of the literature reveals a sprinkling of papers indicating that simpler methods not only carry less morbidity, but also are associated with a lower recurrence rate. With a detailed 10-year review, the author reports a series of 72 consecutive patients with pilonidal sinus treated successfully as outpatients by conservative methods under local anesthesia. This review, along with the similar experience of others, makes it clear that only simple conservative methods are acceptable in the management of pilonidal sinus.