Introduction: Pilonidal sinus is a common disease in sacrococcygeal area, which mostly caught young people and cause disability, which needs complete rest at home and taking off from work. Although the surgical treatment of this problem goes back to the last century, still optimal treatment is a controversy. Recent studies have raised different surgical approaches, so that there is no general agreement
for the surgical technique. The only agreement in regards to the treatment of pilonidal sinus abscess is incision and drainage.

Methods: This prospective study was performed on 96 patients. Patients were divided to two groups. Group A was treated with surgery and primary repair and group B was treated with surgery and secondary repair. Patients in both groups were followed up one year after surgery.

Results: The patients in group A were treated with primary repair using local flap and the patients in group B were treated with open wound. Recurrence didn’t occur in either group. Infection occurred in 9 patients in group A and 7 patient in group B, which all were controlled locally.In 7 patients open wound slightly occurred, which was controlled locally.

Conclusion: Indicators such as duration of complete remission, walk without pain, sitting without discomfort and time returning to work were used, which all were better and faster in group A.

Keywords: Pilonidal sinus, Primary repair, Advance flap, Secondary repair