Excision and Primary Closure Using the Karydakis Flap for the Treatment of Pilonidal Disease: Outcomes from a Single Institution

Pilonidal disease presents with a range of signs and symptoms: asymptomatic pits in the natal cleft, acute abscesses, chronic disease with persistent, discharging sinuses, or recurrent disease following previous attempts at treatment. It primarily affects the sacrococcygeal region and is a disease of young adults, generally male, and leads to pain, disability, and time lost from work. The treatment for an acute pilonidal abscess is widely accepted to be incision and drainage with the incision placed out of the natal cleft. The treatment of chronic and recurrent disease is contentious with excision and then either healing by secondary intention, primary closure, or flap closure all being suggested alongside other less aggressive approaches aimed at conserving tissue. Currently none of these treatments is ideal, although primary closure in the midline has been shown to be inferior and should not be performed.

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Limberg Flap Versus Primary Closure in the Treatment of Primary Sacrococcygeal Pilonidal Disease; A Randomized Clinical Trial

Indian Journal of Surgery ◽

10.1007/s12262-012-0430-y ◽

2012 ◽

Vol 75 (3) ◽

pp. 192-194 ◽

Cited By ~ 14

Author(s):

Parwez Sajad Khan ◽

Humera Hayat ◽

Gazala Hayat

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Primary Closure ◽

Pilonidal Disease ◽

Limberg Flap

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Surgical Treatment of the Pilonidal Disease: Primary Closure or Flap Reconstruction After Excision

Diseases of the Colon & Rectum ◽

10.1007/s10350-008-9436-8 ◽

2008 ◽

Vol 51 (12) ◽

pp. 1816-1822 ◽

Cited By ~ 67

Author(s):

T. Mahdy

Keyword(s):

Surgical Treatment ◽

Primary Closure ◽

Pilonidal Disease ◽

Flap Reconstruction

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EP-1054: Disease Outcomes following Post-operative IMRT for Oral Cavity Cancer: A Single Institution Analysis

Radiotherapy and Oncology ◽

10.1016/s0167-8140(17)31490-1 ◽

2017 ◽

Vol 123 ◽

pp. S580-S581

Author(s):

A. Michaelidou ◽

M. Lei ◽

T. Guerrero Urbano

Keyword(s):

Oral Cavity ◽

Oral Cavity Cancer ◽

Single Institution ◽

Disease Outcomes

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Is Wide Local Excision for Pilonidal Disease Still Justified?

The American Surgeon ◽

10.1177/000313480707301034 ◽

2007 ◽

Vol 73 (10) ◽

pp. 1075-1078 ◽

Cited By ~ 8

Author(s):

Talar Tejirian ◽

Jenny J. Lee ◽

Maher A. Abbas

Keyword(s):

Postoperative Complications ◽

Local Excision ◽

Retrospective Review ◽

Wide Local Excision ◽

Pilonidal Disease ◽

Optimal Operation ◽

Initial Operation ◽

Single Institution ◽

Ongoing Debate ◽

Mean Time

There is an ongoing debate regarding the optimal operation for chronic pilonidal disease. The current study analyzes the outcome of wide local excision (WLE) compared with unroofing and marsupialization (UM) as primary intervention for chronic pilonidal disease. A retrospective review of a single institution experience over a 5-year period was performed. Sixty-eight patients were treated for pilonidal disease. Their mean age was 25 years. There were 42 males (62%) and 26 females (38%). Twenty-six patients underwent WLE and 42 had UM. The type of operation was based on surgeon preference, but individual surgeons were consistent with their choice. Mean time for final healing was significantly higher for WLE compared with UM (21 vs 6 weeks, P < 0.01). Postoperative complications and reoperative rate were significantly higher in the WLE group ( P < 0.01). Nine patients in the WLE group (35%) required one or more reoperations compared with only one (2%) in the UM group ( P < 0.01). This study demonstrates that WLE carries a high complication and reoperative rate. UM should be considered as the initial operation for most patients with pilonidal disease.

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