Surgical treatment of pilonidal sinus by means of Z-plasty – case report and literature review

Introduction. Pilonidal sinus is a chronic inflammation located in the intergluteal cleft. Despite the fact that the first case study of surgical treatment of the disease dates back to 1847, the therapy of pilonidal sinus still poses a great challenge to surgical departments in our country.
Objective. To present a patient suffering from pilonidal sinus treated surgically by means of Z-plasty and to review the latest literature referring to this problem.
Case report. A 30-year-old patient suffering from pilonidal sinus was admitted to the Department of General and Vascular Surgery of the Pirogow Specialist Hospital in Lodz to undergo planned surgery. A complete surgical excision of the pilonidal sinus was performed accompanied by Z-plasty. The postoperative period was without complications and the patient is being followed up in the Proctological Outpatient Department. Five months after the surgery no recurrence of the pilonidal sinus has been observed.
Conclusions. The results of surgical treatment of pilonidal sinus in our country are still not fully satisfactory due to frequent recurrences. A broad excision of the lesion followed by Z-plasty guarantees successful treatment of patients with this disease. The authors of this article believe that due to multiple complications and recurrences following surgical treatment of the pilonidal sinus in general surgery departments, this type of surgical treatment should be performed only in highly specialized wards, where many such procedures are performed.