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Objective  To evaluate crystallized phenol application and the Karydakis flap procedure in terms of treatment success, postoperative complications, and recurrence in the treatment of pilonidal sinus disease (PSD).  Materials and methods  The study included patients who underwent the Karydakis flap procedure and crystallized phenol application with the diagnosis of PSD in our clinic between June 2016 and January 2019. Age, gender, preoperative body mass index (BMI), sinus number, number of crystallized phenol administrations, postoperative length of hospital stay, postoperative complications, and recurrence rates were compared between the Karydakis and crystallized phenol groups.  Results  Of the 88 patients included in the study, 29 (32.95%) were female, and 59 (67.05%) were male. The median age was 30 (27-33) years, and BMI was 29 (26-32) kg/m 2 . The median sinus number was 3 (2-3). There was no difference between the two groups in terms of age, BMI, sinus number, follow-up duration, gender, recurrence, wound infection, hematoma, wound dehiscence, and preoperative complaints (p > 0.05). A higher rate of drain requirement and more extended hospital stay were observed in the Karydakis group than in the crystallized phenol group, and the difference was statistically significant (p < 0.01 and p < 0.01, respectively).  Conclusion  The crucial advantages of crystallized phenol treatment in PSD are high wound healing rates, outpatient applicability, and no requirement of operating room conditions. Crystallized phenol application also has similar post-application complication rates to the Karydakis flap procedure. The results of our study support that crystallized phenol application is a less invasive alternative treatment method that can be applied before surgical treatment in selected patients.

Comparison of Crystallized Phenol Application and the Karydakis Flap Technique in the Treatment of Sacrococcygeally Localized Pilonidal Sinus Disease