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A Modified Method in Treatment of Pilonidal Disease

Seymour A. Vander, MD
Arch Surg. 1968;97(5):739-743. doi:10.1001/archsurg.1968.01340050079010.
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PILONIDAL infection is a commonly occurring medical problem. It is an interesting problem in many respects, as shown by the voluminous writings of this relatively minor medical problem. Many ideas are expressed regarding the etiologic aspects and recommended therapy. Dissatisfaction with our present methods of treatment is evident because of the variety of ideas advanced to modify the standard procedures in use. High recurrence rates prevail, and the experience of most practicing surgeons is that what is fundamentally a simple situation, namely the excision of chronic infection with repair of the defect created, results in a greater challenge than we like to see.

Three Basic Approaches  The Closed Method.—The advantage of this method is the lower morbidity and reduced postoperative care necessary. The disadvantages are due to the difficulties inherent in closing a large defect. Undue tension or failure to obliterate dead spaces will lead to a breakdown of


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