الفهرس 
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Abstract
Pilonidal disease is a disease of young people, usually men, which can result in an abscess, draining sinus tracts, and moderate debility for some.
The aetiology remains unknown, but the acquired theory has become the most accepted one for the great majority of adult pilonidal infection. Thus, radical removal of all tissues overlying the sacrum should not be regarded as essential to treatment.
Therapy should be simple, inflect minimal pain, has a short hospitalization, has a low recurrence rate, require minimal wound care, and allow rapid return to normal activity.
Numerous surgical procedures are employed, and despite numerous studies that have been conducted so far, there has not been universal agreement about the perfect procedure for pilonidal disease.
The open technique offers a simple rapid well-known solution for the disease with the ability to deal with all pathologic situations. However, it has its burden on the patient in terms of long hospitalization, number of postoperative visits and time spent until complete healing.
Primary closure technique saves the patient from a long period of disability. However, it shows a higher infection and recurrence rate.
The treatment of pilonidal sinus by means of cyst excision and skin-flap reconstruction; like karydakis flap is also somewhat complex; however, it is easy to perform, offers radical cure in the majority of situations with minimal disability.