Bacground: There are different methods for surgical management of sacrococcygeal pilonidal disease (SPD), each a different outcome. The present study compares the outcome of surgical excision and simple suture with that of rhomboid excision and the Limberg flap procedure in patients with primary SPD.

Materials and Methods: One hundred SPD patients were randomly allocated to undergo either surgical excision and simple suture (group 1, n=50) or rhomboid excision and the Limberg flap procedure (group 2, n=50). Duration of operation, postoperative pain, time for first mobilization, postoperative complications, time for disease recurrence were recorded for all patients.

Results: Duration of operation was longer in group 2 patients compared to group 1 (P< 0·001). However, postoperative pain was less (P<0·001), mobilization earlier (P<0·001) and postoperative complications fewer (P<0·001) in group 2.

Conclusion: Because of its low complication and acceptable long-term results, rhomboid surgical excision and Limberg flap procedure is preferable for simple surgical excising and suturing in the treatment of SPD.