Z-plasty for treatment of disease of the pilonidal sinus.

The theory of acquired origin of pilonidal sinus disease has been emphasized. Advantages of Z-plasty over the other surgical methods for treatment of this disease have been elaborated. The extremely low recurrence rate following Z-plasty for pilonidal sinus results from the fact that the operation was planned with the true physiopathology of the disease in mind. It is the deep intergluteal fold which predisposes to pilonidal sinuses, and this architecture is materially altered with the Z-plasty. In a series of 120 patients, there were only two recurrences and only five hematomas and wound abscesses. There were no necrosis of flaps and no wound disruptions. This represents an improvement over the results of other modalities of treatment of this disease.