Objective To explore a technology system for the treatment of the complex sacrococcygeal pilonidal sinus, which has a higher incision healing rate.

Methods The range of the complex sacrococcygeal pilonidal sinus was determined by physical examination, color Doppler ultrasound, computed tomograph, or magnetic resonance imaging preoperatively. The pilonidal sinus was completely resected. A triangular fasciocutaneous flap was designed and obtained in accordance with the incision shape, the elasticity, the mobility, and the tension of the surrounding skin. External diameter of the flap was 1 cm greater than the incision. The flap length to width ratio was 2:1-3:1. Epidermis and dermis of the flap end were removed, the left superficial and deep fascia were filled into the gap of the bottom of the incision. In order to make the flap cling to the incision, comprehensive measures were adopted, which based on full hip elastic compression bandage and continuous negative pressure drainage. The measures could prevent poor incision healing.

Results From June 2010 to September 2019, 11 cases of complex sacrococcygeal pilonidal sinus were subjected to the technology system. The flap ends in 3 cases had mild blood circulation disorder, which was recovered after simple treatments. All incisions were healed on schedule, without dehiscence occurred. All patients were followed up for 6 to 36 months (median 22 months). No recurrence occurred during the follow-up period.

Conclusions The above technical system has a good and stable curative effect on the complex sacrococcygeal pilonidal sinus. The incidence of poor incision healing was significantly reduced. However, the exact curative effect needs to be confirmed by further observation with a larger sample size.