Refining Surgical Techniques in Recurrent Pilonidal Sinus Disease: A Simultaneous Procedure Approach

Relevance. Recurrent pilonidal sinus disease (PSD) remains a significant challenge in surgical practice due to its high recurrence rate, prolonged wound healing, and considerable impact on patients’ quality of life. Conventional surgical techniques often fail to provide long-term resolution, especially in patients requiring additional operations for concomitant surgical pathologies. Optimization of surgical tactics—particularly through the use of simultaneous procedures and off-midline flap reconstruction—offers a promising approach to improving outcomes in recurrent PSD.