ABSTRACT
Many procedures have been described for the management of symptomatic pilonidal sinus, none of which, judged by the yardsticks of primary healing and recurrence of disease, is perfect. In our study, we are trying to compare the results of two widely practiced flap techniques, the Karydakis asymmetrical unilateral sliding flap and the rhomboid transposition flap suggested by Azab et al.1984. Forty patients were randomly divided into two groups. The first group was 20 patients and was treated by Karydakis flap. The second group was 20 patients and treated by rhomboid. The mean duration of symptoms was 7 months. The two groups were compared for age, sex, severity of the disease, operation time, complications and recurrence. Results and Discussion: We reported no great difference in recurrence rate [2 patients in Karydakis operation group and 1 patient in Rhomboid flap group], and also no great difference in the postoperative complications. The difference was recorded in the mean operative time [75 min in Karydakis flap group and 120 in Rhomboid flap group] and hospital stay [2 -5 days in Karydakis flap group and 7-9 days in Rhomboid flap group] and this reflects that the Rhomboid flap is more techniqually demanding procedure and so the patient usually needs to stay longer at hospital. The more complexity of the procedure explains the slight increase in the incidence of the postoperative complications