title: S-plasty for pilonidal disease: modified primary closure reducing tension.
abstract: OBJECTIVE
  S-plasty for pilonidal disease reduces the tension on the midline by distributing it diagonally and flattening the natal cleft. The aim of this study was to evaluate the outcomes of S-plasty on simple midline primary closure and the clinical features of pilonidal patients in a low incidence country.
  
  
  METHODS
  S-plasty was applied on 17 patients from July 2008 to October 2010. Data of these patients were collected with computerized prospective database forms during a perioperative period and via telephone interview for follow-up. Surgical site infection (SSI) was defined according to the Center for Disease Control guidelines. The severity of surgical site infection was graded.
  
  
  RESULTS
  All patients were treated with primary S-plasty. Two patients (11.7%) developed low grade SSI. The average healing time after S-plasty was 18.1 days. No recurrences were observed. The mean follow-up period was 13.5 months (range, 6 to 33 months).
  
  
  CONCLUSIONS
  We have shown that primary S-plasty for pilonidal disease is simple, and its surgical outcomes are compatible to the results of other surgical treatments. We present primary S-plasty as a feasible treatment option in a low incidence country.
authors.affiliation: Department of Surgery, Armed Forces Capital Hospital, Seongnam, Korea.
authors.forename: Jae Keun
authors.initials: JK
authors.lastname: Kim
authors.forename: Jin Cheol
authors.initials: JC
authors.lastname: Jeong
authors.forename: Joung Bum
authors.initials: JB
authors.lastname: Lee
authors.forename: Kuk Hyun
authors.initials: KH
authors.lastname: Jung
authors.forename: Byong Ku
authors.initials: BK
authors.lastname: Bae