Benha Journal of Applied Sciences (BJAS) print : ISSN 2356–9751 Vol.(6) Issue(2) Part (1) (2021), (9-13) online : ISSN 2356–976x http://bjas.bu.edu.eg Benha Journal Of Applied Sciences, Vol.(6) Issue(2) Part (1) (2021( Pilonidal Sinus, Minimal Excision and Simple Direct Closure Versus Wide Local Excision and Flap Reconstruction E.M.Kilany, H.M.Sobieh, E.M.Oraby and A.S.Ahmed General surgery,Dept., Faculty of Medicine, Benha Univ., Benha, Egypt E-Mail:ahmed@gmail.com Abstract A pilonidal sinus is a sinus that contains hair, primarily in the sacrococcygeal region, due to preferring conditions like: The presence of a profound natal split and the presence of hair inside the separated, perspiring, maceration, bacterial tainting, and entrance of hair. The point of this examination was to analyze between the results of insignificant extraction of pilonidal sinus lot with basic direct conclusion versus wide extraction with rotational rhomboid fold conclusion. This investigation included 50 patients experiencing 1ry non intermittent sacrococcygeal pilonidal sinus. They were arbitrarily partitioned into 2 gatherings. The primary gathering (25 patients) was exposed to negligible extraction of the pilonidal sinus plot and straightforward direct conclusion while patients of the subsequent gathering (25 patients) were exposed to wide neighborhood extraction and rotational rhomboid fold reproduction. there were no critical contrasts among the two gatherings as for age or sex conveyance. Likewise no critical distinction in contamination, seroma, disturbance and repeat rates yet insignificant extraction of the pilonidal sinus parcel and straightforward direct conclusion was altogether more limited in usable time, Post- employable clinic stay, recuperating time and early re-visitation of work. The natal separated in the rhomboid fold gathering can be leveled, and tissue can be approximated without strain. rhomboid fold procedure in pilonidal sinus medical procedure almost equivalent in the vast majority of static's to insignificant extraction of the pilonidal sinus plot and basic direct conclusion in1ry non repetitive sacrococcygeal pilonidal sinus. Keywords: Pilonidal,Sinus, Excision, Flap, Reconstruction. 1. Introduction In 1833, Herbert Mayo depicted a hair-containing sinus, however it was not until 1880 that Hodge recommended the expression "pilonidal" (Latin: pilus = hair and nidus = home) [1]. By definition, a pilonidal sinus is a sinus that contains hair, mostly in the sacrococcygeal territory, due to preferring conditions like: The presence of a profound natal parted and the presence of hair inside the split, perspiring, maceration, bacterial pollution, and entrance of hair [2]. The inception of pilonidal illness isn't completely perceived. There are two hypotheses related with its pathogenesis: the procured and the innate speculations. Nonetheless, most of assessment favors the gained hypothesis, which proposes that the sacrococcygeal pilonidal disease begins in a natal separated hair follicle that has gotten expanded with keratin [3]. Akinci expressed that the occurrence pace of pilonidal infection is around 0.7%, male are influenced 2.2-multiple times more much of the time than female [4]. Various procedures have been depicted for treatment of pilonidal sinus like phenol infusion, cryosurgery, diathermy coagulation, straightforward cut and seepage and Excision either without stitch or joined with one of a few techniques for essential conclusion is a significant option [5]. Skin folds have likewise been depicted to cover the sacral imperfection after wide extraction. This keeps the scar off the midline and smoothes the natal split [6]. In spite of the debate about the best careful procedure for the treatment of pilonidal sinus, yet there is an agreement around the ideal activity which ought to be basic, ought not need a delayed clinic stay, ought to have a low repeat rate, and ought to be related with insignificant torment and wound consideration, and abatement patients' time off work [2]. The point of this examination was to look at between the results of negligible extraction of pilonidal sinus lot with straightforward direct conclusion versus wide extraction with rotational rhomboid fold conclusion. 2. Patients and methods This examination was performed on 50 back to back patients experiencing 1ry non-intermittent sacrococcygeal pilonidal sinus; tasks for all patients were done at Benha University Hospital, Patients were arbitrarily isolated into two gatherings: Gathering (A): included 25 patients treated by negligible extraction of the pilonidal sinus parcel and straightforward direct conclusion. Gathering (B): included 25 patients treated by wide neighborhood extraction and rotational rhomboid fold remaking Prior to medical procedure, a structure was readied, and patients age, sex, span of indications, preoperative anti-toxin use, past therapies, length of emergency clinic stay, get back to work, complexities like injury disrubtion, seroma, disease and repeat were noted. All patients were conceded to clinic the day preceding a medical procedure and worked under broad sedation. The natal separated was shaved the day preceding the medical procedure. The patients were put in horizontal situation on the surgical table with the legs marginally kidnapped and the bottom tied separated by glue tapes on the table. Shut attractions channels were set in expected space taking all things together patients independent of strategy utilized and eliminated when seepage diminished to 20 mL/d. Patients were seen regularly on the careful ward on postoperative days 5, 10, and 14 for wound review and expulsion of stitches. The patients with delayed mending were kept on being seen in careful ward until complete recuperating or