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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, Controversy for choosing the best surgical technique in order to decrease the recurrence rate, patient discomfort, and Duration of disability after surgery still exists. Therefore, the objective of the present study was to compare results reached from two methods of surgery, tie-over procedure (TOP) and Karydakis procedure(KP) for the treatment of sacrococcygeal pilonidal sinus.  Methods: In this study, 70 patients with a diagnosis of pilonidal sinus disease treated randomly with surgical excision and TOP or KP, in two 35 patients group, in the educational hospital by the same surgeon, between 2009 and 2010, and followed up until December 2019.  Results: Achieved data after excision of sacrococcygeal pilonidal sinus indicate that primary closure of the wound by tie-over sutures have a better result than KP in order of Pain sore during the first month after surgery (P&lt; 0.001), Duration of disability (P &lt;0.001), wound repair time (P &lt;0.001) and Patient satisfaction(P=0.019).  Conclusion: Overall, these results show the TOP instead of KP, because higher acceptance results may be an alternative better for the treatment of chronic pilonidal sinus for the patients who have surgery scheduled for them.

Comparison between the tie-over and Karydakis procedure in chronic sacrococcygeal pilonidal sinus