Abstract
Background
 There are controversies about the etiology and management of pilonidal sinus. The numbers of techniques are testament in treating pilonidal sinus (PNS) and no single procedure is superior in all aspects.
 Objectives
 The Purpose of this study was to evaluate two operative procedures regarding its complications including recurrences of the disease.
 Methods
 The medical records of 40 patients in whom the Rhomboid Flap and Z-Plasty techniques were applied for reconstruction after the excision were evaluated retrospectively.
 Results
 The incidence rates of postoperative hematoma 1 (2.5%), wound infection 3 (7.5%), seroma 1 (2.5%), sinus formation 1 (2.5%) and neurological symptoms 17 (42.5%) activities were achieved after a mean of 21.20 days. During the average follow-up of 24 months, three patients (7.5%) developed recurrent disease.
 Conclusion
 Rhomboid flap and Z-plasty technique are flattening of the natal cleft, thus reducing local recurrence rates. Hence, we recommend use of flap technique for pilonidal sinus patients; Z-plasty is cosmetically more accepted as it has less postoperative complication.
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