Comparative Analysis of Primary Closure, Rhomboid Flap, and Open Technique in Pilonidal Sinus Surgery: A Retrospective Cohort Study

Objective: Pilonidal sinus disease (PSD) is a common condition in young adults, with multiple surgical options available. The optimal technique remains debated due to trade-offs between recurrence, healing time, and patient satisfaction. This study aims to compare outcomes of primary closure, rhomboid flap, and open excision in the surgical management of PSD.Methods: A retrospective cohort study was conducted on 300 patients treated between December 2024 and January 2015. Patients were grouped by technique: primary closure (n = 100), rhomboid flap (n = 100), and open excision (n = 100). Baseline characteristics, operative time, postoperative pain (VAS), length of stay, time to complete healing, Time to return to work , complications, recurrence, and satisfaction were analyzed. Statistical tests included Kruskal–Wallis for continuous variables and Chi-square for categorical variables (P