Karydakis procedure for sacrococcygeal pilonidal sinus disease: Our experience

ABSTRACT

Aim: The purpose of this study was to evaluate patients with sacrococcygeal pilonidal sinus disease (SPSD) who underwent Karydakis procedure at our centre with reference to the perioperative findings, early and late postoperative results and recurrence. Materials and Methods: A total of 103 patients presenting with SPSD at our centre underwent Karydakis flap repair from January 2001 to December 2010. These patients were then followed-up and evaluated with respect to operative time, drain use, hospital stay, suture removal, complications, and recurrence. Results: The mean operative time was 74.9 min with a median hospital stay of 5 days. Drains were removed at a median of 7 days and sutures at a median of 15 days. Twenty-one patients presented with serous collection in the wound. Six patients had wound infection. Patients were followed-up for a median of 29 months. No recurrences were noted in any of the cases. Conclusion: Karydakis flap procedure is a relatively simple procedure for SPSD with reproducible low recurrence rates.

KEY WORDS

Complications - Karydakis flap repair - recurrence - sacrococcygeal pilonidal sinus disease

• REFERENCES

• 1 Goligher J. Pilonidal sinus. In: Goligher J. editor Surgery of the Anus, Colon and Rectum. London: Balliere Tindall; 1984: p. 221-36
• 2 Buie LA. Jeep disease (pilonidal disease of mechanized warfare). Dis Colon Rectum 1982; 25: 384-90
• 3 Søndenaa K, Andersen E, Nesvik I, Søreide JA. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis 1995; 10: 39-42
• 4 Bendewald FP, Cima RR. Pilonidal disease. Clin Colon Rectal Surg 2007; 20: 86-95
• 5 Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg 1992; 62: 385-9
• 6 Hull TL, Wu J. Pilonidal disease. Surg Clin North Am 2002; 82: 1169-85
• 7 Awad MM, Elbaset AA, Ebraheem S, Tantawy E, Elhafez MA, Elsayed AM. A scoring system as a method to evaluate pilonidal sinus disease to make an easy decision for its management. Indian J Plast Surg 2009; 42: 43-8
• 8 Gönenç M, Yýrgýn H, Dinç M, Kapan A, Turhan AN, Alýþ H. Karydakis flap for sacrococcygeal pilonidal sinus disease: Long-term outcomes. A retrospective analysis. Med J Bakýrköy 2011; 7: 153-5
• 9 Kitchen PR. Pilonidal sinus: Experience with the Karydakis flap. Br J Surg 1996; 83: 1452-5
• 10 Anyanwu AC, Hossain S, Williams A, Montgomery AC. Karydakis operation for sacrococcygeal pilonidal sinus disease: Experience in a district general hospital. Ann R Coll Surg Engl 1998; 80: 197-9
• 11 Amir M. Karydakis flap operation for chronic pilonidal sinus. Pak J Surg 2007; 23: 65-9
• 12 Monro RS, Mcdermott FT. The elimination of causal factors in pilonidal sinus treated by Z-plasty. Br J Surg 1965; 52: 177-81
• 13 Roth RF, Moorman WL. Treatment of pilonidal sinus and cyst by conservative excision and W-plasty closure. Plast Reconstr Surg 1977; 60: 412-5
• 14 Urhan MK, Kücükel F, Topgul K, Ozer I, Sari S. Rhomboid excision and Limberg flap for managing pilonidal sinus: Results of 102 cases. Dis Colon Rectum 2002; 45: 656-9
• 15 Awad MM, Saad KM, Tolba AM, Gharib OH. A simple novel technique for closure of simple and complex pilonidal sinus with either simple (tongueshaped) or bilobed rotation flap. Indian J Plast Surg 2007; 40: 47-50
• 16 Awad MM, Saad KM. Does closure of chronic pilonidal sinus still remain a matter of debate after bilateral rotation flap? (N-shaped closure technique). Indian J Plast Surg 2006; 39: 157-62