Complex and recurrent pilonidal sinuses are best treated with surgery. Different surgical modalities as complete excision of the pilonidal sinus leave the wound open or procedures like closing the wound with or without reconstructive flap are widely used. The open procedure is radical but may cause broad excision and prolonged morbidity, while risk of infection and rate of recurrence are higher in the closed techniques. Traditional Chinese surgical treatments are less invasive and more effective; they have been used to treat sinus and fistula disease successfully. In this case report, we have described a male adolescent with complex pilonidal sinus, who received traditional Chinese surgical treatment combined with modern wound healing technique. He recovered completely with short hospitalization, good tolerance, less pain, and scarring. Therefore, we recommend using this integrative method to treat complex pilonidal sinus disease. 1. Introduction Pilonidal disease was first described by Hodges in 1880. It is diagnosed by finding a characteristic epithelial track situated in the skin of the natal cleft, a short distance behind the anus and generally containing hair [1]. The onset of pilonidal sinus (PNS) usually begins between the age of 15 and 40. The incidence in males is nearly ten times that in females [2]. The etiology is unclear; hormones, hair, friction, and infection may be the majority of pathological origins of PNS. Male sex, adolescence of youth, familial disposition, local trauma, and overweight seem to be associated with the development of PNS [3]. Acute PNS needs to be drained, may include debris removal and wound packing. Complex and recurrent PNS are best treated with surgery. Clinically, patients with complex PNS are more common. Low recurrence rate, minimal operation time, convenience, short time off work, and cost are important considerations [4]. The number and variety of published techniques are testament to the complexity of treating PNS and the fact that no single procedure is superior in all respects. The surgical management of the complex and recurrent PNS is controversial. The majority of procedures can be classified into first, excision and healing by second intention, and second, excision with primary closure or reconstructive flap. The advantage of the first procedure is low recurrence, but the downside is a prolonged healing time (8–10 weeks) [5]. Closure of the wound after excision is more cosmetically acceptable for patients and is associated with a shorter healing time but coupled with high risk of postoperative infection
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