Pilonidal sinus disease: Karydakis flap procedure in our patients.

Abstract

Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be afrustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Atotal of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in ashort-term follow-up period. Disease recurrence was defined as prolonged healing or as anew disease requiring repeated surgery. In December 2019 all 27 patients came for afollow-up visit. The result was afully lateralized wound without any signs of anew disease in all patients. In May 2020 afollow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. According to the available evidence and guidelines, off-midline procedures - the Karydakis flap, Bascom cleft lift, and Limberg flap procedures - are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in anicely flattened gluteal crease.