Prospective Evaluation of a Single-Sided Innervated Gluteal Artery Perforator Flap for Reconstruction of Extensive and Recurrent Pilonidal Sinus Disease: Functional, Aesthetic, and Patient-Reported Long-Term Outcomes

Background: Pilonidal sinus disease (PSD) is a chronic troublesome pathology of the natal cleft of the sacrococcygeal region, with an estimated incidence of 26 cases in every 100,000 inhabitants. The aim of this review is to give a snapshot of the current literature on the endoscopic approach to PSD.Methods: A search on endoscopic treatment of pilonidal disease was performed according to PRISMA guidelines, adopting the following search terms: (pilonidal OR sacrococcygeal) and (endoscopic OR VAAPS OR EPSiT OR minimally invasive OR video-assisted OR video assisted).Results: Thirty-four articles were included in the final analysis, among which 23 were on adults and 11 were on pediatric population. The endoscopic approach is associated with painless postoperative pain, good aesthetic results, short time off work, and high patient satisfaction.Despite these advantages in short-term outcomes, results on recurrence rate in a long-term follow up are needed to definitively confirm the importance of this technique.Conclusions: The endoscopic approach is associated with significant postoperative advantages over other standard surgical approaches, and it should be included in the surgical portfolio for the treatment of PSD. According to the Italian guidelines, this technique could be considered as the gold standard for limited PSD. However, the favorable short-term-outcomes and lack of reliable data on long-term follow-up must be a stimulus to perform further high-quality studies to give definitive conclusions on this technique.

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Management of Pilonidal Sinus Disease with the Aesthetically Shaped Parasacral Perforator Flap

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000006087 ◽

2019 ◽

Vol 144 (4) ◽

pp. 971-980

Author(s):

Benoit Chaput ◽

Christian Herlin ◽

Jérémie Jacques ◽

Charline Berthier ◽

Thomas Meresse ◽

...

Keyword(s):

Pilonidal Sinus ◽

Perforator Flap ◽

Pilonidal Sinus Disease ◽

Sinus Disease

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Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study

The American Journal of Surgery ◽

10.1016/j.amjsurg.2010.10.021 ◽

2011 ◽

Vol 202 (5) ◽

pp. 568-573 ◽

Cited By ~ 52

Author(s):

Mustafa Ates ◽

Abuzer Dirican ◽

Mehmet Sarac ◽

Ahmet Aslan ◽

Cemil Colak

Keyword(s):

Pilonidal Sinus ◽

Randomized Study ◽

Long Term Results ◽

Prospective Randomized Study ◽

Pilonidal Sinus Disease ◽

Limberg Flap ◽

Sinus Disease ◽

Short And Long Term

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Pilonidal sinus- limberg versus karidakis flap our experience at SIMS, Shivamogga

International Surgery Journal ◽

10.18203/2349-2902.isj20174878 ◽

2017 ◽

Vol 4 (11) ◽

pp. 3641

Author(s):

Madhusudhan A. ◽

Madhan D. P. Swamy ◽

Mohhamad Arif

Keyword(s):

Pilonidal Sinus ◽

Long Term Results ◽

Pilonidal Sinus Disease ◽

Surgical Removal ◽

Limberg Flap ◽

Sinus Disease ◽

Number Of Patients ◽

Successful Recovery ◽

Surgical Methods

Background: The etiology and pathogenesis of sacro-coccygeal pilonidal sinus are not clear. The pathogenesis of the disease is hypothesized to be related to the accumulation of weak and lifeless hair in the intergluteal region, which over time gives rise to foreign body reaction, causing abscess and sinus formation. A deep natal cleft with one of favourable factors enhance sacro-coccygeal pilonidal sinus, e.g., sweating, maceration, bacterial contamination and penetration of hairs. Obesity, trauma, local irritation and a sedentary lifestyle are usually associated with PS. Although pilonidal sinus can be treated using various conservative and surgical methods, recurrence rate remains high. Complete surgical removal of the pilonidal sinus or sinuses and appropriate reconstruction can lead to successful recovery. However, collection of the lifeless hair depends on the anatomy of the intergluteal area, and accompanying risk factors can lead to subsequent recurrence.Methods: The objective of this study is to compare the immediate post-operative and long-term results of Limberg flap and Karydakis flap, which are being widely used now to treat pilonidal sinus disease. It was a retrospective observational study where the patients (total number of patients-30) who underwent both the procedures were compared, Limberg flap (LF; n = 13) and Karydakis flap (KF; n = 17).Results: Present study found out that short and long-term results of the LF and KF procedures are similar. In present study we also noted that all patients with pilonidal sinus disease were men, and most of them had jobs which involved sitting for long durations. Poor hygiene and hirsutism however was not noted in most of the patients, and was not objectively assessed.Conclusions: Both the techniques can be used safely and effectively in sacro coccygeal pilonidal sinus disease.

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