ObjectiveTo compare the clinical therapeutic efficacy of the pilonidal sinus with four kinds of surgical procedures. MethodsThe clinical data of 43 patients with sacrococcygeal pilonidal sinus treated from January 2008 to March 2013 were analyzed retrospectively. All of them were received surgery, in who 4 patients underwent pilonidal sinus resection alone(incision open group), 7 patients underwent incision and direct suturing after pilonidal sinus resection (incision and direct suturing group), 19 patients underwent marsupialization after pilonidal sinus resection(marsupialization group), and 13 patients underwent Limberg flap transposition after pilonidal sinus resection(rhombus flap transposition group). Results①There were not statistically significant differences regarding demographics among four groups (P > 0.05). 2 The hospital stay was(16.70±8.69) d, (16.43±10.68) d, (15.84±11.29) d, and(14.69±4.01) d in the incision open group, incision and direct suturing group, marsupialization group, and flap transposition group, respectively, and the healing time of incision was(64.75±6.50) d, (34.57±19.15) d, (35.16±15.49) d, and(17.92±4.29)d among the same four groups, respectively. The difference of the hospital stay was not statistically significant among four groups(P > 0.05). The healing time of incision in the flap transposition group was less than that in the other three groups(P < 0.05), which in the incision and direct suturing group and marsupialization group were shorter than those in the incision open group(P < 0.05), and which had no significant difference between the incision and direct suturing group and marsupialization group(P > 0.05).③The partial wound dehiscence occured in two patients and the wound was partially broken because of infection in two patients in the incision and direct suturing group. One patient was performed drainage because of emhysis and the wound tension blisters occurred in one patient in the flap transposition group. There was no complications in the other two groups. There was no recurrence after the wound healing of follow-up six months. ConclusionsAccording to this limited preliminary data, the selection of wound closure method depends on the incision tension. Direct suturing can be the choice for incision with lower tension. The marsupialization can be the choice for incision with higher tension. The Limberg flap transposition can be the choice for incision with extensive disease or postoperative recurrence.