Abstract
Aim: The purpose of this study was to evaluate patients with sacrococcygeal pilonidal sinus disease(SPSD) who underwent the Karydakis procedure and Z plasty at our centre concerning theperioperative findings, late postoperative results and recurrence. Patients and Methods: A total of30 patients presenting with SPSD at our centre underwent Karydakis flap repair and Z plasty fromMay 2019 to June 2021. These patients were then followed up and evaluated concerning operativetime, drain use, hospital stay, suture removal, complications, and recurrence. The adipocutaneousflap of Karydakis was devised to shift the natal cleft, while Z-plasty involves a fasciocutaneous flap.Results: The mean operative time was 60 min with a median hospital stay of 4 days. Drains wereremoved at a median of 5 days and sutures at a median of 15 days. The duration of hospitalisationfor the Karydakis procedure was found significantly lesser than that for Z-plasty Patients who werefollowed up for a median of 12 months. The overall complications were more in Z-plasty. Flapnecrosis developed in 30 % of the cases in the Z-plasty group, comparable to no recurrence seen inthe Karydakis procedure. Conclusion: Karydakis flap was found superior to Z-plasty, having lessseroma formation, no flap necrosis and no local hematoma Karydakis flap procedure is a relativelysimple procedure for SPSD and has advantages over Z-plasty technique like keeping scar away fromthe midline and flattening of the natal cleft, thus reducing local recurrence rates.
Highlights
Pilonidal sinus disease (SPSD) is a global problem with a propensity for recurrence that causes significant problems if not dealt with appropriately in the primary setting
A higher incidence of the disease is noted among males and army recruits.[1]
All patients subjected to the Karydakis procedure, Z plasty into two divided groups for PSD at our centre were included in the study whether presenting with primary or recurrent disease
Summary
Pilonidal sinus disease (SPSD) is a global problem with a propensity for recurrence that causes significant problems if not dealt with appropriately in the primary setting. A higher incidence of the disease is noted among males and army recruits.[1] Early pilonidal changes are amplified due to deep tissue disruption from moisture, anaerobic conditions, hairs, and bacteria.[2,3]. The focus of treatment should be actions to change the conditions that attack epidermis, rather than wide excision, which attacks deep and healable tissue excision with midline closure, oblique excision and asymmetric closure, Karydakis and z plasty procedures. Karydakis procedure is a gluteal advancement flap [2]. Z-plasty is a fasciocutaneous flap; Karydakis flap is an adipocutaneous flap; it is, technically easier, less bloody, and less time consuming; it has a better cosmetic outcome, a single, lateral, longitudinal scar; and it requires a significantly shorter hospital stay
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