comparison between the tie-over and karydakis procedure in chronic sacrococcygeal pilonidal sinus

Background and aims: pilonidal sinus in the sacrococcygeal region is a disease with high postoperative morbidity and discomfort for the patient. although there are various therapeutic modalities to manage these patients, there is still controversy about choosing the best surgical technique to decrease the recurrence rate, patient discomfort, and duration of disability after surgery. the present study aimed to compare the results obtained from two surgery methods including tie-over procedure (top) and karydakis procedure (kp) for the treatment of sacrococcygeal pilonidal sinus. methods: in this single-blind clinical trial, 70 patients with the diagnosis of pilonidal sinus disease were divided into two equal groups (n=35 each) and treated randomly with surgical excision and top or kp by the same surgeon in the kashani educational hospital in shahrekord, iran from 2009 and 2011. the patients were followed up until december 2019. results: according to the results, after excision of sacrococcygeal pilonidal sinus, the primary closure of the wound by tie-over sutures had better results than kp in order of pain sore during the first month after surgery (p < 0.001), duration of disability (p < 0.001), wound repair time (p < 0.001), and patient satisfaction (p = 0.019). conclusion: our results showed top was a better procedure compared to kp for the treatment of chronic pilonidal sinus due to higher acceptance results in patients undergoing surgery.