Kabaklioğlu, M.Kaya, M.2021-12-012021-12-0120211307671Xhttps://doi.org/10.18678/dtfd.928180https://hdl.handle.net/20.500.12684/9851Aim: Although the pilonidal sinus disease is commonly treated with surgical methods, search for optimal surgical procedures and minimally invasive methods continues. The aim of this study was to evaluate the inverted '?' technique which provides a tension-free closure with minimal tissue loss, by comparing with the classical open surgery technique. Material and Methods: Sixty-five patients, 37 (56.9%) male and 28 (43.1%) female, with a mean age of 15.85±1.82 years, admitted between January 2014 and October 2020 and underwent inverted '?' surgery and classical midline open surgery were retrospectively evaluated. Results: As an early postoperative complication, bleeding was observed in 2 (7.4%) patients in inverted '?' group and 3 (11.1%) patients had wound infection. The same complications were 4 (10.5%) and 4 (10.5%) in classical group, respectively. The time to return to full activities was statistically different between two groups (10.36±0.43 versus 11.30±0.93 days, p<0.001). During the follow-up period, 1 (3.7%) recurrence in the inverted '?' group and 9 (23.7%) recurrences in the classical group were statistically significant (p=0.037). Conclusion: The present technique aims to remove the pathological tissue that causes sacrococcygeal pilonidal disease by the subcutaneous surgical work area under the flap created through the '?' incision and to close it without tension, away from the midline without tissue loss. We believe that the operation involving the '?' incision and primary suture method should be considered as the first choice in the pediatric patient group because of being a simple and effective surgical technique for sacrococcygeal pilonidal disease treatment. © 2021, Duzce University Medical School. All rights reserved.en10.18678/dtfd.928180info:eu-repo/semantics/openAccessChildrenSacrococcygeal sinus diseaseSurgeryArticle2321811862-s2.0-85113817761Q4