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Pilonidal sinus is a frequently encountered condition in young adults. It is commonly found in the mid-line skin that covers sacrum and coccyx. Sinus can be found elsewhere, sometimes between the fingers in hair dressers, and in the umbilicus. It is characterized by chronic inflammation in one or more sinuses in the mid-line of the natal cleft that contain hairs and debris. Pilonidal disease is a significant social and economic problem affecting predominantly young males in the second decade of life. This study aimed to compare the results of excision and midline closure with those of lateral approach (Modified Bascom's procedure) in the treatment of sacro-coccygeal pilonidal sinus in regard to the duration of the procedure and wound complication. This prospective randomized study was performed on 53 patients operated upon for a pilonidal sinus between June 2014 and December 2015 in Al-Sadir Teaching Hospital in Basrah. Patients were divided into two groups randomly. Group A (25) patients underwent modified Bascom procedure and group B (19) patients underwent excision and midline closure. The modified Bascom technique showed a significantly short wound healing time (30±10 days) compared to primary closure (55±25 days), p<0.01. The duration of this procedure was significantly longer(50±15 minute) in comparison with excision and midline closure (30±15 minutes) p< 0.01. No significant differences between the two groups regarding bleeding, wound infection, seroma formation and recurrence were recorded. In conclusion, modified Bascom procedure is feasible, effective and applicable for all patients with pilonidal sinus. It is of particular advantages in the treatment of complex, recurrent and chronic non-healing pilonidal sinuses when wound healing remains an important dilemma in the surgical treatment. Introduction ilonidal sinus is a frequently encountered. These sinuses and cysts are commonly found in the mid-line skin that cover sacrum & coccyx. Although usually found near the coccyx, the condition can also affect the navel, armpit or genital region, though these locations are much rarer. Pilonidal disease is a significant social and economic problem, affecting predominantly young males in the second decade of life. It is a common suffering among the military; it has been referred to as ‘jeep disease’. Incidence is reported at 26 per 100,000 population. Pilonidal disease was first described by Mayo in 1833, but it took quite some time before etiology and pathogenesis were elucidated. Initially considered an infection of subcutaneous ectodermal remnants present because of imperfect embryological development. Pilonidal sinus disease is now generally believed to be an acquired condition. Karydakis described the causative process extensively, explaining the three factors which are necessary to cause pilonidal disease; Invading loose hair, which could also originate from the back or neck, some force causing hair insertion, for example riding in a jeep, and the loss of barrier function of the skin in a deep and wet natal cleft with maceration and bacterial colonization. This barrier function is also lost in a surgical scar in P

EXCISION WITH MIDLINE CLOSURE VERSUS MODIFIED BASCOM PROCEDURE IN TREATMENT OF SACROCOCYGEAL PILONIDAL SINUS