Lambeau perforant pour couverture des kystes sacrococcygiens : à propos de 8 cas

Abstract

Multiple surgical revisions (exeresis and directed healing) of recurrent pilonidal cysts are sources of unstable scars. Chronic ulcerations often appear with or without authentic recidivism. A local fasciocutaneous perforating flap based on the parasacral arteries would bring healthy tissue and avoid the disadvantages of conventional techniques (musculo-cutaneous or random).A series of 8 cases of transposition flap covering based on parasacral perforators, in multi-operated patients. The perforators are identified by Doppler probe before the gesture, then the flap is traced obliquely according to the size of the loss of substance. The gesture is short, not morbid and accessible to all by a technique that excludes fine dissection of the pedicle. The duration of hospitalization is 2days.Despite two minor and resolving complications (a hematoma and a disunion of the donor sit) the healing was complete and without recurrence in all patients at 2years, with 100% satisfaction.This reliable and reproducible simple flap becomes the reference technique in our department for the sequelae of recurrent sacro-coccygeal cyst.