Pilonidal sinus: has off-midline closure become the gold standard?

2009 ◽  
Vol 79 (1-2) ◽  
pp. 4-5 ◽  
Author(s):  
Paul Kitchen
Keyword(s):  
Pilonidal Sinus ◽  
Gold Standard ◽  
Midline Closure

scholarly journals Comparison of Primary Midline Closure, Limberg Flap, and Karydakis Flap Techniques in Pilonidal Sinus Surgery

2018 ◽  
Vol 24 ◽  
pp. 8959-8963 ◽  
Author(s):  
Murathan Erkent ◽  
İbrahim Tayfun Şahiner ◽  
Mesut Bala ◽  
Murat Kendirci ◽  
Murat Baki Yıldırım ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Sinus Surgery ◽  
Limberg Flap ◽  
Midline Closure

scholarly journals Prospective randomized study of surgical treatment of pilonidal sinus; primary midline closure after elliptical excision versus rhomboid excision with limberg flap reconstruction versus open excision and healing by secondary intention

2017 ◽  
Vol 4 (11) ◽  
pp. 3646
Author(s):  
Rajneesh Kumar ◽  
Ankur Hastir ◽  
Ramandeep S. Walia ◽  
Subhash Goyal ◽  
Amandeep Kaur
Keyword(s):  
Surgical Treatment ◽  
Pilonidal Sinus ◽  
Healing Time ◽  
Limberg Flap ◽  
Flap Reconstruction ◽  
Group I ◽  
Group Ii ◽  
Open Excision ◽  
Midline Closure ◽  
Rhomboid Excision

Background: Best surgical treatment of pilonidal sinus is always challenging for a surgeon in term of recurrence. Evaluation of surgical treatment of pilonidal sinus; primary midline closure after elliptical excision versus rhomboid excision with limberg flap reconstruction versus open excision and healing by secondary intention of sacrococcygeal pilonidal disease.Methods: In this prospective randomized study of 75 patients of sacrococcygeal pilonidal sinus were divided into 3 equal groups through randomly assigning the type of surgery. 25 patients of each group. Group I was operated by primary midline closure after elliptical excision, Group II rhomboid excision with limberg flap reconstruction and Group III open excision and healing by secondary intention.Results: Data was assessed between three groups in term of operative time, healing time and recurrence over a follow up period of 1 year. Mean operative time in group I (primary midline closure after elliptical excision) was 38.7±5.1 minutes, group II (Rhomboid excision with Limberg flap reconstruction) was 124.2±5.6 minutes, group III (Open excision and healing by secondary intention) was 20.6±5.6 minutes. Mean healing time for group I was 19.0±7.4 days, for group II was 17.0±8.0 days and for group III was 60±9.6 days. Recurrence occurred in 3 patients in group I and nil in group II and III.Conclusions: Rhomboid excision with limberg flap reconstruction is better choice than primary midline closure after elliptical excision and open excision in terms of healing time and reoccurrence in cases of sacrococcygeal pilonidal sinus.

scholarly journals Outcome of Excision with Primary Midline Closure for Sacrococcygeal Pilonidal Sinus Disease

2020 ◽  
pp. 19-26
Author(s):  
Bahzad Waso Hamad
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Chronic Inflammatory Disease ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Public And Private ◽  
Female Ratio ◽  
Sinus Disease ◽  
Postoperative Wound ◽  
Midline Closure

Sacrococcygeal Pilonidal sinus disease is common chronic inflammatory disease affecting chiefly young adult male . It cause much discomfort and morbidity and affect negatively the quality of life of patients. There are various techniques of surgical treatment for the chronic sinuses but still there is no gold standard one. The aim of this study to report our experience with excision and midline closure technique of chronic Sacrococcygeal Pilonidal sinus disease and to identify the outcome of the procedure for postoperative wound complications and recurrence rate. This is a retrospective study with telephone contact and review of 36 patients operated for Sacrococcygeal pilonidal sinus disease from January 2011 through January 2016 under care of one consultant surgeon (the Author) in Public and Private Hospitals in Rania, Sulaimani, Iraq. Inclusion criteria was all patients with chronic midline located sinuses without evidence of acute inflammation. Exclusion criteria was all infected ,off midline located sinuses and recurrent sinuses. Elliptical Excision of the sinuses with primary midline closure over a vacuum drainage performed. End point of this study was rate of wound complications and recurrence of sinus. Thirty six patients with median age 22 years (range 14-40) with 24/12 male /female ratio. Median follow up was 24 months (12 - 66 months), the recurrence occurred in 3/36 ( 8.3%) patients at a median of 12 months (range 5 - 48), failure of treatment in 5/36 (13.9%) patients, and postoperative wound complications was seen in 5/36 ( 13.9%) patients. In the conclusion, excision and primary midline closure is simple, effective and preferable procedure for management of uncomplicated Sacrococcygeal pilonidal sinus disease associated with early wound healing and low rate of postoperative wound complications and recurrence rate.

Randomized prospective comparison of midline and off-midline closure techniques in pilonidal sinus surgery

Surgery ◽  
2016 ◽  
Vol 159 (3) ◽  
pp. 749-754 ◽  
Author(s):  
Barış Sevinç ◽  
Ömer Karahan ◽  
Ahmet Okuş ◽  
Serden Ay ◽  
Nergis Aksoy ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Sinus Surgery ◽  
Prospective Comparison ◽  
Midline Closure

scholarly journals Lateral advancement flap for sacrococcygeal pilonidal sinus: reassessment study

2017 ◽  
Vol 4 (6) ◽  
pp. 1968
Author(s):  
Bhavinder K. Arora ◽  
Rachit Arora ◽  
Akshit Arora
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Wound Dehiscence ◽  
Advancement Flap ◽  
Pilonidal Sinus Disease ◽  
Average Hospital ◽  
Sinus Disease ◽  
Aesthetic Results ◽  
Midline Closure

Background: Sacrococcygeal pilonidal sinus disease is treated better with various flaps and primary closure. This study was aimed to describe the lateral advancement flap in surgical treatment of sacrococcygeal pilonidal sinus disease in an effort to redefine the results of this technique. It is a fascio-adipo-cutaneous flap which is advanced from one buttock to opposite across the natal cleft and providing the off midline closure with cleft lift.Methods: The results of this technique were assessed in 65 patients. The technique consists of adequate excisions of sinus, tracts and surrounding inflamed tissue till depth of presacral fascia. The defect was covered with a thick lateral advancement flap and produce an off midline closure and cleft lift.Results: The sixty patients were hirsute males and five were hairless females. The maximum length and breadth covered was 7x5cm. The operative time taken was 40±10 minutes. The average hospital stay was 5 to 7 days. The surgical site infection in 4 patients and wound dehiscence occurred in one patient only. No recurrence was recorded in follow up period of one year.Conclusions: The lateral fascio-cutaneous advancement flap is gaining popularity for its ease of designing and harvesting. The short hospital stay, minimum postoperative complications, no recurrence and acceptable aesthetic results make this a uniformly acceptable technique for surgical primary closure of pilonidal sinus disease.

scholarly journals EFFECTIVENESS OF GLUTEUS MAXIMUS FASCIA PLASTY FLAP FOR CLOSURE OF WOUND IN SURGICAL TREATMENT OF PILONIDAL DISEASE

2018 ◽  
Vol 24 (5) ◽  
pp. 233-236
Author(s):  
Yury E. Kitsenko ◽  
D. D Shlyk ◽  
I. A Tulina ◽  
D. R Markaryan ◽  
P. V Tsarkov
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Subcutaneous Tissue ◽  
Subcutaneous Fat ◽  
Operation Time ◽  
Gluteus Maximus ◽  
Long Term Results ◽  
Midline Closure ◽  
Fascia Flap

Aim: to compare short- and long-term results of primary midline closure and gluteus maximus fascia flap plasty after pilonidal sinus excision. Method: retrospective analysis included consecutive patients who had primary and recurrent pilonidal sinus excised. Patients with gluteus maximus fascia flap plasty formed 1st group, patients with primary midline closure formed 2nd group. Gluteus maximus fascia flap plasty technique: (i) separation in lateral directions of both gluteus maximus fascia from muscle and subcutaneous tissue; (ii) mobilised fascia flaps are brought together to midline and sutured; (iii) subcutaneous fat and skin sutured. Results: 60 patients operated in 2007-2016 were included: 28 in 1st group, 32 in 2nd group. Groups 1 and 2 didn’t differ in operation time (41.9±4.0 and 37.3±3.1 min, p=0.4), blood loss (6.9±0.5 and 8.3±1.6 ml, p=0.2), draining rate (7.1% and 12.5%, p=0.5), hospital stay (11.8±1.3 and 9.1±1.0 days, p=0.1), time to complete wound epithelialization (1.2±0.2 and 1.5±0.4 months, p=0.37). Mean follow-up was 20.7±3.2 and 53.8±6.5 months respectively. Recurrence rate was significantly lower in gluteus maximus fascia flap plasty group (3.6%) than in the 2nd group (21.9%, p=0.04). Conclusion: gluteus maximus fascia flap plasty after pilonidal sinus excision is feasible, doesn’t increase postoperative complications rate and leads to a lower recurrence rate compared to midline closure.

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