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Published in: World Journal of Surgery 6/2018

01-06-2018 | Original Scientific Report

Fascio-Adipo-Cutaneous Lateral Advancement Flap for Treatment of Pilonidal Sinus: A Modification of the Karydakis Operation—Cohort Study

Authors: Mohammad Hamdy Abo-Ryia, Hamdy Sedky Abd-Allah, Mahmoud Moustafa Al-Shareef, Mahmoud Mohammed Abdulrazek

Published in: World Journal of Surgery | Issue 6/2018

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Abstract

Background

Pilonidal sinus is a common chronic disease affecting young adults. Many surgical procedures have been developed for its treatment, but an optimal one has still not been achieved. This study presents a modification to the Karydakis operation.

Methods

A total of 265 patients with chronic pilonidal sinus between May 2008 and May 2015 were included in this study and submitted to fascio-adipo-cutaneous lateral advancement flap as 1-day case surgery. Any Septic complication was treated firstly. Follow-up examinations were conducted during the first three postoperative months at the outpatient clinic at regular intervals and thereafter by phone calls or direct examination to check for recurrences.

Results

Males constituted 93.6% with a mean age of 21.6 ± 7.7 year. The median disease duration was 15 months. Twenty-eight patients had recurrent disease. The mean operative time was 41.4 ± 12.7 min. The mean time out of work was 11.6 ± 4.6 days. Complications occurred in 19 patients (7.1%) in the form of seroma in six patients (2.2%), superficial wound infection occurred in nine patients (3.3%), cuticular wound disruption occurred in four patients (1.5%). All patients completed 3-months follow-up, but 48 patients were lost at variable intervals with the remaining 217 patients completed follow-up throughout the period of the study with a median follow-up of 43 months. No reported recurrence and 96.7% of the patients were satisfied about their wound.

Conclusion

This modification is simple with low complication rate, no recurrence, and excellent patient satisfaction.
Literature
1.
go back to reference Karaca T, Yoldas Ö, Bilgin BC et al (2012) Comparison of short-term results of modified Karydakis flap and modified Limberg flap for pilonidal sinus surgery. IJS 10:601–606 Karaca T, Yoldas Ö, Bilgin BC et al (2012) Comparison of short-term results of modified Karydakis flap and modified Limberg flap for pilonidal sinus surgery. IJS 10:601–606
2.
go back to reference Armstrong JH, Barcia PJ (1994) Pilonidal sinus disease. The conservative approach. Arch Surg 129:914–917CrossRefPubMed Armstrong JH, Barcia PJ (1994) Pilonidal sinus disease. The conservative approach. Arch Surg 129:914–917CrossRefPubMed
4.
go back to reference Sondenaa K, Andersen E, Nesvik I et al (1995) Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis 10:39–42CrossRefPubMed Sondenaa K, Andersen E, Nesvik I et al (1995) Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis 10:39–42CrossRefPubMed
5.
go back to reference Akinci OF, Coskun A, Uzunkoy A (2000) Simple and effective surgical treatment of pilonidal sinus: asymmetric excision and primary closure using suction drain and subcuticular skin closure. Dis Colon Rectum 43:701–707CrossRefPubMed Akinci OF, Coskun A, Uzunkoy A (2000) Simple and effective surgical treatment of pilonidal sinus: asymmetric excision and primary closure using suction drain and subcuticular skin closure. Dis Colon Rectum 43:701–707CrossRefPubMed
6.
go back to reference Akinci OF, Kurt M, Terzi A et al (2009) Natal cleft deeper in patients with pilonidal sinus: implications for choice of surgical procedure. Dis Colon Rectum 52:1000–1002CrossRefPubMed Akinci OF, Kurt M, Terzi A et al (2009) Natal cleft deeper in patients with pilonidal sinus: implications for choice of surgical procedure. Dis Colon Rectum 52:1000–1002CrossRefPubMed
7.
go back to reference Ates M, Dirican A, Sarac A, Aslan A, Colak C (2011) Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study. Am J Surg 202:568–573CrossRefPubMed Ates M, Dirican A, Sarac A, Aslan A, Colak C (2011) Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study. Am J Surg 202:568–573CrossRefPubMed
8.
go back to reference Petersen S, Koch R, Stelzner S, Wendlandt TP, Ludwig K (2002) Primary closure techniques in chronic pilonidal sinus: a survey of the results of different surgical approaches. Dis Colon Rectum 45:1458–1467CrossRefPubMed Petersen S, Koch R, Stelzner S, Wendlandt TP, Ludwig K (2002) Primary closure techniques in chronic pilonidal sinus: a survey of the results of different surgical approaches. Dis Colon Rectum 45:1458–1467CrossRefPubMed
10.
go back to reference Kitchen PR (2009) Pilonidal sinus: has off-midline closure become the gold standard? ANZ J Surg 79:4–5CrossRefPubMed Kitchen PR (2009) Pilonidal sinus: has off-midline closure become the gold standard? ANZ J Surg 79:4–5CrossRefPubMed
11.
go back to reference McCallum IJD, King PM, Bruce J (2008) Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ 336:868–871CrossRefPubMedPubMedCentral McCallum IJD, King PM, Bruce J (2008) Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ 336:868–871CrossRefPubMedPubMedCentral
12.
13.
go back to reference Bascom J, Bascom T (2002) Failed pilonidal surgery: new paradigm and new operation leading to cures. Arch Surg 137:1146–1150 (discussion 1151) CrossRefPubMed Bascom J, Bascom T (2002) Failed pilonidal surgery: new paradigm and new operation leading to cures. Arch Surg 137:1146–1150 (discussion 1151) CrossRefPubMed
14.
15.
go back to reference Bessa SS (2007) Results of the lateral advancing flap operation (modified Karydakis procedure) for the management of pilonidal disease. Dis Colon Rectum 50:1935–1940CrossRefPubMed Bessa SS (2007) Results of the lateral advancing flap operation (modified Karydakis procedure) for the management of pilonidal disease. Dis Colon Rectum 50:1935–1940CrossRefPubMed
16.
go back to reference Milad NM, Rihan M, Ibrahim A (2011) Fascio-cutaneous Cleft closure: a simple modification of Karydakis technique for pilonidal sinus Kasr El Aini. J Surg 12:19–26 Milad NM, Rihan M, Ibrahim A (2011) Fascio-cutaneous Cleft closure: a simple modification of Karydakis technique for pilonidal sinus Kasr El Aini. J Surg 12:19–26
17.
go back to reference Karydakis GE (1992) Easy and successful treatment of pilonidal sinus after explanation of its causative process. ANZ J Surg 62:385–389CrossRef Karydakis GE (1992) Easy and successful treatment of pilonidal sinus after explanation of its causative process. ANZ J Surg 62:385–389CrossRef
18.
go back to reference Gurer A, Gomceli I, Ozdogan M, Ozlem N, Sozen S, Aydin R (2005) Is routine cavity drainage necessary in Karydakis flap operation? A prospective, randomized trial. Dis Colon Rectum 48:1797–1799CrossRefPubMed Gurer A, Gomceli I, Ozdogan M, Ozlem N, Sozen S, Aydin R (2005) Is routine cavity drainage necessary in Karydakis flap operation? A prospective, randomized trial. Dis Colon Rectum 48:1797–1799CrossRefPubMed
19.
go back to reference Sakr M, El-Hammadi H, Moussa M, Arafa S, Rasheed M (2003) The effect of obesity on the results of Karydakis technique for the management of chronic pilonidal sinus. Int J Colorectal Dis 18:36–39CrossRefPubMed Sakr M, El-Hammadi H, Moussa M, Arafa S, Rasheed M (2003) The effect of obesity on the results of Karydakis technique for the management of chronic pilonidal sinus. Int J Colorectal Dis 18:36–39CrossRefPubMed
20.
go back to reference Anyanwu AC, Hossain S, Williams A, Montgomery AC (1998) Karydakis operation for sacrococcygeal pilonidal sinus disease: experience in a district general hospital. Ann R Coll Surg Engl 80:197–199PubMedPubMedCentral Anyanwu AC, Hossain S, Williams A, Montgomery AC (1998) Karydakis operation for sacrococcygeal pilonidal sinus disease: experience in a district general hospital. Ann R Coll Surg Engl 80:197–199PubMedPubMedCentral
21.
go back to reference Kronborg O, Christensen KI, Zimmermann-Nielsen O (1986) Chronic pilonidaI disease: a randomized trial with complete 3-year follow up. Br J Surg 72:303–304CrossRef Kronborg O, Christensen KI, Zimmermann-Nielsen O (1986) Chronic pilonidaI disease: a randomized trial with complete 3-year follow up. Br J Surg 72:303–304CrossRef
Metadata
Title
Fascio-Adipo-Cutaneous Lateral Advancement Flap for Treatment of Pilonidal Sinus: A Modification of the Karydakis Operation—Cohort Study
Authors
Mohammad Hamdy Abo-Ryia
Hamdy Sedky Abd-Allah
Mahmoud Moustafa Al-Shareef
Mahmoud Mohammed Abdulrazek
Publication date
01-06-2018
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-4406-8

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