Gluteal fascial advancement: an innovative, effective method for treating pilonidal disease.

The ideal elective surgical procedure for pilonidal disease is debated. Simple excision and closure is commonly performed but is associated with a high incidence of wound complications and recurrence. We developed a simple modification of primary closure, which involves the elevation, mobilization, and closure of the gluteal fascia. The purpose of this study is to compare outcomes of this gluteal fascial advancement technique with standard primary closure for the treatment of pilonidal disease. We retrospectively reviewed our surgical database to include all patients who underwent surgery for pilonidal disease from 2004 to 2007. Patients who underwent primary closure (n = 66) were compared with patients who underwent gluteal fascial advancement (n = 17). Demographic data as well as recurrence and the incidence of wound complications were examined. There was a significant difference in incidence of wound breakdown (0 vs 21%), recurrence (0 vs 20%), and early wound drainage (6 vs 32%). Overall there was an 80 per cent reduction in wound complications after gluteal fascial advancement compared with primary closure. Gluteal fascial advancement is a simple modification of standard primary closure and is associated with fewer wound complications and recurrences.