Pilonidal disease is a condition caused by hair being sucked into the pits on ones backside causing recurring infections. Sinus tracts can form with tunnels under the skin. This was one of the more complex repairs I have done (most are much easier to treat) requiring a combination of a cleft lift and rhomboid flap to excise all of the disease and reconstruct the extensive defect.
Note: this is not a typical case. This patient had extensive disease with multiple sinus tracts requiring an extended excision and reconstruction. Most surgeries are much more straightforward with smaller wounds and faster recovery etc.