Aim. To analyze the outcomes in patients with epithelial coccygeal course (ECC) after original vacuum-therapy. Material and methods. The study included 61 patients with ECC. Patients were divided into 3 groups: 22 patients underwent ECC excision followed by wound closure by Donati, ECC excision with following wound management with ointment swathes was used in 19 cases, vacuum-therapy of open wound was conducted in 20 patients. Results. In group 1 hospital-stay was 11±1.9 days (ranged 3—20, Me=11), time of complete wound healing — 14.9±4.9 days (ranged 8—49, Me=12.5), early postoperative complications were observed in 5 (22.7%) patients, recurrence — in 3 (13.6%) cases. In group 2 hospital-stay was 13.7±2.6 days (ranged 3—25, Me=15), time of complete wound healing — 74±5,7 days (ranged 35—112, Me=57,0), early postoperative complications were observed in 2 (10.5%) patients, recurrence — in 1 (5.3%) case. In group 3 hospital-stay was 13.9±2.3 days (ranged 5—24, Me=15), time of complete wound healing — 31.1±2.7 days (ranged 15—39, Me=31.0), complications and recurrences were absent. Conclusion. Vacuum therapy improves surgical results compared with conventional treatment.