Although much as been written on the surgical treatment of pilonidal sinus, the subject remains unsettled. The literature abounds with a variety of statistics and opinions. Surgeons seem to fall into two groups: those who favor primary suture * and those who favor some type of open operation.† The former believe that recurrences should be no greater with primary closure than with the open operation. They add that, although the patient may require a longer period of hospitalization postoperatively, he does not require after-care following discharge from the hospital. Furthermore, the patient does not have the prolonged discomfort that accompanies an open wound. The latter believe, in general, that recurrence rates are lower, complications fewer, and hospitalization shorter than with the closed technique. They tend to minimize the inconvenience of an open wound.
After reviewing the statistics it becomes obvious that differences of opinion transcend philosophical considerations. For instance, following primary
PECORA DV, COOPER P. Pilonidal SinusAnalysis of Two Hundred Six Operations Performed According to Varying Techniques. AMA Arch Surg. 1955;71(5):752-755. doi:10.1001/archsurg.1955.01270170110020