Background: Since many cases of pilonidal disease end in an open wound following extensive excision, many techniques have been developed over time to aid in the healing of intricate open pilonidal wounds. Long-term daily dressings and a delayed return to regular life are linked to open wounds. The use of vacuum-assisted wound healing equipment has been one of the other tactics. This method is linked to a quicker recovery period and a shorter time frame before returning to a regular life. In this study, we therefore sought to evaluate the effectiveness and safety of the vacuum-assisted open approach in the treatment of pilonidal disease.

Methods: This prospective, randomized comparative clinical trial was carried out at the Department of General Surgery in Zagazig University Hospitals and Elmbra Insurance Hospital, from Jan 2024 to Jan 2025 on 26 symptomatic simple chronic sacrococcygeal pilonidal Sinus. Patients were divided into: group I: Conventional open Technique. Packing wound with gauze and lay open to heal with secondary intention and group II: Vacuum assisted open technique.

Results: Postoperative follow up showed clinically better outcome (no infection of recurrent) in vacuum group than open alone, while statistically no significant differences between studied group.

Conclusion: Sinus resection combined with closed negative pressure drainage of the wound is more effective in the treatment of sacrococcygeal pilonidal sinus than simple sinus resection and suture. It can effectively return time of patients, reduce the incidence of postoperative complications, and result in small postoperative scars, good aesthetic effects, and higher patient satisfaction.