الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Pilonidal sinus disease (PNS) is a simple chronic inflammatory condition resulting from loose hairs forcibly inserted into vulnerable tissue in the natal cleft. It is an acquired disease with a slight familial tendency. There is no agreement on optimum treatment and the multitude of therapeutic options cannot be compared due to the lack of a universally adopted classification of the disease.
Ideally, the method used to treat the patient should satisfy following goals: Wound healing with a low risk of recurrence; Short hospitalization; Maximal patient comfort; Low morbidity, with few wound-management problems; Early resumption to normal daily activity.
The ideal operation for pilonidal sinus disease should be a simple one with low complication and recurrence rates. This is achieved by flap techniques which flatten the natal cleft with an off-midline closure.
The aim of this study was to compare Dufourmental flap versus conventional rhomboid (Limberg flap) in treatment of complex pilonidal sinus regarding the early post-operative complications and aesthetic outcomes.
In this interventional comparative clinical study, 64 patients with the diagnosis of pilonidal sinus disease were admitted to the department of General Surgery, Benha University Hospitals and Al-Ahrar teaching hospital for definitive surgical management from January 2022 to October 2023. The patients divided into two groups, each included 32 patients:
• group (A): Underwent Dufourmental flap technique.
• group (B): Underwent Limberg flap technique.
Before proceeding to surgery, history was taken from all patients regarding duration of symptoms and history of abscess. patients were evaluated clinically to assess the number of pits and the extent of the disease. The laboratory investigations were checked to exclude any patients with contraindication to surgery.
The mean age of group A was 25.3±7.4 years while the mean age in group B was 25.8±5.8 and a male predominance of 67.2%.The duration of their preoperative complaints in Dufourmental group ranged from 6 to 96 months while in Conventional rhomboid ranged from 6 to 84 months.
All patients were followed using a standardized approach for one year.
Follow up visits were scheduled after a week post-surgery and then every two weeks until complete healing then follows throughout thesis full period. Personal hygiene procedures include routine hair removal from the navicular area, taking a shower soon after every haircut. And avoiding prolonged sitting. The patients were examined for assessment of wound healing and complications such as recurrence, seroma, hematoma, and wound infection (SSI).
The difference was significant between our two groups regarding post-operative wound complications. Four cases with infection, discharge and seroma were observed in group (B) patients, while patients of group(A) showed two cases with infection and seroma. Two cases with partial flap loss observed in group (B). The largest percentage of complications found in group (B).
Patient satisfaction was far superior in patients of group (A) who were satisfied with their operation compared to patients of group (B).
Conclusion