The authors report their experience of 31 patients with recalcitrant pilonidal disease. All patients had persistent open wounds and had at least 2 previous operations. The authors describe their operation of choice: the cleft lift. In this procedure, skin is excised from the left gluteus maximus and an advancement flap is created from the right gluteus maximus. The advancement flap redrapes across the cleft and closes the pilonidal wound and the left-sided skin defect. Twenty-eight patients received this operation, with most healing primarily and quickly, and all 31 patients healing eventually.
Weiss EA. Failed Pilonidal Surgery—Invited Critique. Arch Surg. 2002;137(10):1151. doi:10.1001/archsurg.137.10.1151