Comparison of the Rhomboid Fasciocutaneous Transposition Flap with Primary Simple Closure in the Treatment of Uncomplicated Pilonidal Disease

Background Pilonidal disease is a common condition that affects younger people in which over half of the affected patients present with a sacrococcygeal abscess. This study was performed to compare the outcome of excision and primary closure with that of rhomboid excision and flap procedure in patients with uncomplicated pilonidal disease. Methods A total of 90 consecutive patients with pilonidal disease were randomly divided into: group 1 who underwent the rhomboid fasciocutaneous transposition flap procedure (n=45) and group 2 who underwent excision and primary closure (n=45). Length of hospital stay and postoperative complications, which included surgical site infection, seroma and hematoma, as well as the time to resumption of work and early recurrence were compared for all patients. Results Duration of hospital stay (p < 0.001) and time to resumption of work (p < 0.001) was less for group 1. During a median follow-up of 12 months, no recurrence was detected in patients in group 1 whereas six patients developed recurrence in group 2 (p=0.013). Conclusion Rhomboid fasciocutaneous transposition flap procedure, with its acceptable long-term results and shorter hospital stay, is preferable to simple excision and primary closure in the treatment of uncomplicated pilonidal disease.