Management of recurrent pilonidal sinus by simple V-Y fasciocutaneous flap

PURPOSE: Several methods of managing the sacrococcygeal pilonidal sinus have been described, and fervent arguments for each form of therapy can be found in the literature. Recurrence unfortunately plagues all forms of therapy, though it is evident that the lowest rates have been reported for procedures involving local flap reconstruction. We conducted this case review to evaluate the validity of a simple reconstructive procedure for recurrent pilonidal disease. METHODS: We describe the application of the V-Y fasciocutaneous advancement flap to reconstruct the defect following radical excision of recurrent pilonidal sinus in five consecutive patients. RESULTS: Tension-free closure offers the benefits of a reduction in postoperative pain, less restriction in activity, and a shorter hospital stay. CONCLUSIONS: Preliminary results offer evidence of the efficacy of the simple reconstructive procedure in the management of difficult cases.