title: Modified off-midline closure of pilonidal sinus disease.
abstract: BACKGROUND
  Numerous surgical procedures have been described for pilonidal sinus disease, but treatment failure and disease recurrence are frequent. Conventional off-midline flap closures have relatively favorable surgical outcomes, but relatively unfavorable cosmetic outcomes.
  
  
  OBJECTIVE
  The author reported outcomes of a new simplified off-midline technique for closure of the defect after complete excision of the sinus tracts.
  
  
  METHODS
  Two hundred patients of both sexes were enrolled for modified D-shaped excisions were used to include all sinuses and their ramifications, with a simplified procedure to close the defect.
  
  
  RESULTS
  The overall wound infection rate was 12%, (12.2% for males and 11.1% for females). Wound disruption was necessitating laying the whole wound open and management as open technique. The overall wound disruption rate was 6%, (6.1% for males and 5.5% for females) and the overall recurrence rate was 7%.
  
  
  CONCLUSIONS
  Our simplified off-midline closure without flap appeared to be comparable to conventional off-midline closure with flap, in terms of wound infection, wound dehiscence, and recurrence. Advantages of the simplified procedure include potentially reduced surgery complexity, reduced surgery time, and improved cosmetic outcome.
authors.affiliation: Department of General Surgery, Port-Fouad General Hospital, Port-Fouad, Port-Said, Egypt.
authors.forename: Aly
authors.initials: A
authors.lastname: Saber
keywords: Modified; off-midline closure; pilonidal sinus