Background: Pilonidal sinus disease is a common surgical concern for 20- and 30-year-old males. Surgery is the most acceptable management. Surgical recurrence and wound infections are rare especially with Wide excision. It leaves a large midline incision that takes months to heal and may lower quality of life. The optimal therapy is debatable. Karydakis flap and Modified Bascom are two promising surgical techniques.
Objectives: The aim of this study is to evaluate early postoperative outcomes and satisfaction of patients with Pilonidal Sinus (PNS) who underwent either Karydakis flap or Modified Bascom Cleft Lift Procedure at our Department.
Patients and methods: From March 2022 to January 2023, Qena University Hospitals, South Valley University performed a randomized control experiment on 60 pilonidal sinus patients. Metronidazole was administered intravenously before 30 min and after 6 h of all spinal anaesthetic surgeries.
 Results:  The Karydakis group had a greater rate of infection occurrence than the Modified Bascom group (P = 0.0237), but there was no difference in drain removal, hospital stay, post-operative discomfort, or pain. Modified Bascom group required significantly longer time for painless defecation than Karydakis group (P = 0.01773). Both research groups had good to excellent post-operative patient satisfaction.
Conclusion:  Both methods are effective in management of Pilonidal Sinus with no huge distinction. Modified Bascom Technique has a lower risk of infection. However, Karydakis Flap was better to achieve painless defecation in a shorter period of time.