A comparative study between Z-plasty and incision and drainage or excision with marsupialization for pilonidal sinuses.

Pilonidal sinuses are acquired in the natal cleft as a result of dead hairs being pushed into skin abrasions by the movements of the buttock. Traditional surgical approaches have resulted in high recurrence rates. To avoid this, plastic procedures, such as the Z-plasty, have been advocated but have not been generally accepted. In a randomized trial, we compared Z-plasty with incision and drainage or marsupialization and found that no further surgical treatment was required in the Z-plasty group; in the control group, 40 per cent had repeated surgical treatment. We support Z-plasty for pilonidal sinuses.