AGREAT diversity of procedures continue to be recommended for the cure of pilonidal cyst and sinus. Although differing in technical details, it is reassuring to note that there has been a trend away from the more complicated types of operations which involve transposition of muscle bundles and the use of pedicle flaps.
As we view our attempts to successfully excise a relatively small cyst and allowing for the unusual contours of the pilonidal region, it is little short of amazing that the results have been so unsatisfactory, even when a sinus is present and a lowgrade infection complicates the picture. In other parts of the body presenting a similar problem, nothing other than a permanent good result would be expected. However, one can readily visualize healing problems in any area where a large segment of tissue has been excised and closure is associated with tension on wound edges.