title: Semi-closed surgical technique for treatment of pilonidal sinus disease.
abstract: BACKGROUND
  Pilonidal sinus disease (PSD) is a highly debatable disorder regarding its surgical management, despite an assortment of surgical techniques described in the medical literature. The aim of this report is to provide an alternate semi-closed surgical method for treatment of PSD, with early recovery and a satisfactory cosmetic result.
  
  
  METHODS
  In this retrospective study, 34 patients underwent surgical treatment for primary PSD; 32 male and 2 female. Patients were suffering from primary PSD, with the cyst located in the gluteal midline. Total excision of the cyst was performed, while the skin flaps were fixed on the postsacral fascia using absorbable sutures, leaving the wound semi-closed.
  
  
  RESULTS
  Technical success was 100%, with an average operation time of 48.7 ± 3.8 min. No wound dehiscence or infections were recorded postoperatively. One reoperation was performed due to hemorrhage. All patients were discharged on the day after surgery, with a VAS pain score of 1.3 ± 1. Two incidents of late wound dehiscence were recorded at 4th and 6th postoperative day due to strenuous exercise. Patients resumed their work after the 5th postoperative day with no complications. The 6 month follow up was completed in 29 patients, with a VAS cosmetic score of 8.1 ± 0.9. No recurrences were observed during the follow up period.
  
  
  CONCLUSIONS
  The presented semi-closed technique is a viable alternative for surgical management of PSD. It provides patients with a satisfying cosmetic result, while it allows for early and safe return to everyday activities with less pain experienced.
authors.affiliation: 1st Department of Surgery, 401 General Military Hospital of Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Sahsamanis
authors.affiliation: 1st Department of Surgery, 401 General Military Hospital of Athens, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Samaras
authors.affiliation: 1st Department of Surgery, 401 General Military Hospital of Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Mitsopoulos
authors.affiliation: 1st Department of Surgery, 401 General Military Hospital of Athens, Greece.
authors.forename: Titos
authors.initials: T
authors.lastname: Deverakis
authors.affiliation: 1st Department of Surgery, 401 General Military Hospital of Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Dimitrakopoulos
authors.affiliation: 1st Department of Surgery, 401 General Military Hospital of Athens, Greece.
authors.forename: Dionysios
authors.initials: D
authors.lastname: Pinialidis
keywords: Pilonidal cyst; Pilonidal sinus disease; Semi-closed method; Surgical technique