Analysis of illness: Surgery is the main treatment, but it is contraindicated when there is inflammation, and surgery should be performed after the inflammation subsides. There are several surgical methods: 1. One-stage suture surgery removes all diseased tissues, free muscles and skin, and completely sutures the wound to make it heal in the first stage. In order to eliminate the deep luteal fissure and its negative pressure, and reduce the wound dehiscence, hematoma and abscess, Z plasty is feasible (figure 1). It is suitable for cysts and small sinuses with uninfected midline, and the recurrence rate is 0% ~ 37%. Its advantages are short healing time, soft scar activity in gluteal groove, and soft tissue between scar and sacrum, which can tolerate injury. 2. Resection and partial suture were used to remove the diseased tissue. The skin on both sides of the wound was sutured to the sacral fascia, so that most of the wound healed in the first stage and the granulation tissue in the middle part healed. It is suitable for cases with many ostia and sinuses, and the effect is the same as that of primary suture, but the healing time is longer. 3. Open secondary suture is suitable for cases of severe infection and cases of primary suture incision drainage infection. 4. Incision is suitable for cases where the wound is too large to be sutured and the operation recurs. The operation is simple, but the healing period is long, the scar is extensive, and only a thin layer of epithelium adheres to the sacrum. If there is an injury, the scar will break easily. 5. Bag suture was used to remove the surface part and upper skin of sinus wall, and the wound was healed with catgut or absorbable artificial suture. Careful postoperative care can often bring satisfactory results. This is the most common case where the pilonidal sinus cannot be resected or recurred.

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