Treatment of pilonidal sinus by radical excision and reconstruction by rotation flap surgery of Z-plasty technique.

Defects after excision of large pilonidal sinuses were reconstructed by either rotation skin flaps or a Z-plasty technique. Altogether, 16 patients were operated on, 10 with a rotation flap and 6 with a Z-plasty technique. All the patients except one underwent a radical operation. The patient not having a radical operation had a recurrence. Two cases in the Z-plasty groups acquired an infection in the distal part of the wound necessitating reoperation on the resultant sinus. The disability after this more extensive surgery was not more pronounced than after ordinary surgical procedures. For large recurrent pilonidal sinuses, radical excision and primary suturing of the wound using a rotation flap is recommended as the method of choice.