الفهرس 
Relevant AnatomyOnly 14 pages are availabe for public view
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Abstract
Pilonidal sinus (PS) remains a problem for the surgeon and nuisance to the patients. Pilonidal sinus disease is a small hole or tunnel in the skin at the top of the buttocks, where they divide (the natal cleft) usually seen in Young adults and carries high post-operative morbidity and patient discomfort. Complicated pilonidal surgical wounds are associated with considerable morbidity, including chronic sacral wound, loss of work time, and lifestyle limitation.
Aim of the Work: The aim of this current study is to compare between two surgical methods, excision of the recurrent pilonidal sinus and covering the defect using SGAP flap and lay open.
Patients and Methods: After approval of the ethical committee in Ain Shams University, El-demerdash Hospital, the current study was done between August 2020 and September 2021. Informed consent forms from all patients were obtained. It was a prospective study including 40 patients diagnosed with recurrent PNS disease presented to the surgery and plastic clinics of Ain Shams University Hospitals and Nasser Institute Hospital.
Results: Comparison between cases of SGAP flap and cases of Lay open regarding the healing indicated that 100% of SGAP flap cases have good healing while 85% of the lay open cases have good healing, such findings were not statistically significant (P value>0.05). Comparison between cases of SGAP flap and cases of Lay open regarding the infection indicated that 100% of SGAP flap cases have no infection while 50% of the lay open cases have infection, such findings were statistically significant (P value<0.05). Comparison between cases of SGAP flap and cases of Lay open regarding dehiscence indicated no statistically significant differences (P value>0.05), no dehiscence was found among the lay open cases while 10% of the SGAP flap cases have dehiscence. Comparison between cases of SGAP flap and cases of Lay open regarding recurrence indicated a statistically significant increase in recurrence among the Lay open cases in comparison with the SGAP flap cases (P value<0.05). Regarding the flap complications among cases of SGAP flap, the present study revealed that 20% of the SGAP flap cases have congestion and 80% have no complications.
Conclusion: The comparison between two techniques in management of the recurrent pilonidal sinus, excision and covering the defect using SGAP flap and lay open showed that no surgical procedure satisfies the principal requirements of an ideal treatment and each technique has advantages and disadvantages.
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