scholarly journals A Comparative Study on flap necrosis following Karydakis Flap Reconstruction and Z-Plasty in Patients with Sacrococcygeal Pilonidal Disease – Our experience

2021 ◽  
Vol 7 (4) ◽  
pp. 85-90
Author(s):  
Dr. MJ Prabu ◽  
◽  
Dr. R Niranjan Kumar ◽  
Dr. SP Gayathre ◽  
Dr. R Kannan M.S. ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Flap Necrosis ◽  
Recurrence Rates ◽  
Natal Cleft ◽  
Median Hospital Stay ◽  
Stay Suture ◽  
Flap Procedure ◽  
Flap Repair

Aim: The purpose of this study was to evaluate patients with sacrococcygeal pilonidal sinus disease(SPSD) who underwent the Karydakis procedure and Z plasty at our centre concerning theperioperative findings, late postoperative results and recurrence. Patients and Methods: A total of30 patients presenting with SPSD at our centre underwent Karydakis flap repair and Z plasty fromMay 2019 to June 2021. These patients were then followed up and evaluated concerning operativetime, drain use, hospital stay, suture removal, complications, and recurrence. The adipocutaneousflap of Karydakis was devised to shift the natal cleft, while Z-plasty involves a fasciocutaneous flap.Results: The mean operative time was 60 min with a median hospital stay of 4 days. Drains wereremoved at a median of 5 days and sutures at a median of 15 days. The duration of hospitalisationfor the Karydakis procedure was found significantly lesser than that for Z-plasty Patients who werefollowed up for a median of 12 months. The overall complications were more in Z-plasty. Flapnecrosis developed in 30 % of the cases in the Z-plasty group, comparable to no recurrence seen inthe Karydakis procedure. Conclusion: Karydakis flap was found superior to Z-plasty, having lessseroma formation, no flap necrosis and no local hematoma Karydakis flap procedure is a relativelysimple procedure for SPSD and has advantages over Z-plasty technique like keeping scar away fromthe midline and flattening of the natal cleft, thus reducing local recurrence rates.

scholarly journals Karydakis procedure for sacrococcygeal pilonidal sinus disease: Our experience

2014 ◽  
Vol 47 (03) ◽  
pp. 402-406 ◽  
Author(s):  
N. Arun Kumar ◽  
Prasenjit Sutradhar
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Operative Time ◽  
Simple Procedure ◽  
Pilonidal Sinus Disease ◽  
Recurrence Rates ◽  
Sinus Disease ◽  
Stay Suture ◽  
Flap Procedure ◽  
Flap Repair

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.

Study of laser treatment in primary pilonidal disease at a tertiary hospital

2021 ◽  
Vol 19 (1) ◽  
pp. 01-04
Author(s):  
Nitish Jhawar ◽  
Keyword(s):  
Hospital Stay ◽  
Laser Treatment ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Normal Activity ◽  
Tertiary Hospital ◽  
Pilonidal Sinus Disease ◽  
Invasive Technique ◽  
Recurrence Rates ◽  
Vas Score

Background: Pilonidal sinus is a pathology that occurs with acute or chronic infection in the natal cleft, especially in young men. In order to decrease complications and recurrence rates after pilonidal sinus excision, it is desirable to use a less invasive technique that allows patients to recover more quickly and permanently. Present study was aimed to evaluate laser Pilonidotomy, a new technique for the treatment of pilonidal sinus. Material and Methods: Present study was a prospective, observational study conducted in ppatients diagnosed as cases of pilonidal sinus disease, attending surgical OPD, underwent laser pilonidotomy. Results: Total 32 patients were evaluated. Male patients (90.63%) were far more than female patients (9.38%). Mean duration of procedure was 30.34 ± 8.24 minutes, mean duration of hospital stay was 14.65 ± 7.13 hours. Most of patients resumed normal activity in 1.96 ± 0.81 days while complete wound healing by secondary intention was noted after 4.5 ± 1.2 weeks. Successful primary treatment was done in 90.63 %. Recurrence was noted in 3 patients (9.38 %). Infection (6.25 %) was noted in 2 patients, less common complications were bleeding (3.13 %), severe postoperative pain (3.13 %), hypertrophic scar (3.13 %). VAS score analysis was done and a significant change in VAS score was noted between day 1 and day 7. Conclusion: Laser treatment in primary pilonidal disease is minimal invasive surgery, is easy to perform with major advantages such as shorter hospital stay, less post-operative pain and care and the final aesthetic aspect.

scholarly journals A Comparative Study between Karydakis Flap Reconstruction and Double Z-Plasty in Patients with Sacrococcygeal Pilonidal Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ankit Kayal ◽  
Akhlak Hussain ◽  
Anil Choudhary ◽  
Ashok Meghwal
Keyword(s):  
Wound Healing ◽  
Local Recurrence ◽  
Comparative Study ◽  
Pilonidal Disease ◽  
Fasciocutaneous Flap ◽  
Flap Reconstruction ◽  
Flap Necrosis ◽  
Recurrence Rates ◽  
Natal Cleft ◽  
Duration Of Hospitalization

The most difficult problems that follow surgery for pilonidal disease are persistent unhealed midline wound and recurrence. Various innovations were proposed to deal with these problems. The adipocutaneous flap of Karydakis was devised to shift the natal cleft, while Z-plasty involves fasciocutaneous flap. The present prospective randomized trial was conducted on 50 cases of symptomatic or recurrent pilonidal sinuses divided randomly into two equal groups undergoing Karydakis procedure and Z-plasty. The duration of hospitalization for Karydakis procedure was found significantly lesser than that for double Z-plasty (P<0.001). Similar observations are obtained for duration of wound healing (P<0.001), work off period (P<0.001), and the duration of presence of significant pain postoperatively (P<0.001). The overall complications were more in double Z-plasty. Recurrence developed in 32% of the cases in double Z-plasty group comparable to no recurrence seen in Karydakis procedure. Thus, Karydakis flap was found superior to double Z-plasty having less seroma formation, no local hematoma, and no flap necrosis. Statistically, this comparison was highly significant (P<0.001). Karydakis flap has some added advantages over double Z-plasty technique like keeping scar away from the midline and flattening of the natal cleft, thus reducing local recurrence rates.

scholarly journals Anatomic effect of classical Limberg plastic surgery procedure in the sacro-coccygeal region for pilonidal sinus disease - A pilot study

2016 ◽  
Author(s):  
Michael Ardelt ◽  
Gregor Hallof ◽  
Rene Fahrner ◽  
Felix Dondorf ◽  
Stefan Ludewig ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Statistical Significance ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Recurrence Rates ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Rima Ani ◽  
Background Data ◽  
Male Patients

Abstract Objective Sacro-coccygeal pilonidal sinus disease is a frequent surgical problem. Some authors assign the low recurrence rates of the Limberg flap to the flattening or elevation of the natal cleft. Summery of the background data: Numerous authors describe a flattening or elevation of the natal cleft as a result of a Limberg flap that originated from the gluteal region. However, thus far these were not quantified. Methods The aim of our study was to quantify the flattening or elevation, respectively, of the natal cleft. In the context of our study on the Limberg flap plasty with a homogenous group of 12 male patients, we measured the depth of the rima ani after the excision and we also measured the thickness of the Limberg flap. Results The median thickness of the rima ani at excision was 3.35 cm [IQR: 2.70; 4.18]. The median thickness of the Limberg flap was 4.85 cm [IQR: 3.90; 5.18]. The thickness of the rima ani after excision was statistically significantly less as compared to the thickness of the Limberg flap (p = 0.002). Conclusion In our study, we have shown the elevation of the crena ani with statistical significance by performing the Limberg flap for the treatment of sacro-coccygeal pilonidal sinus disease, leading to a flattening of the sacro-coccygeal region. As a deep crena ani is a factor in the pathogenesis of pilonidal sinus, the flattening of the sacro-coccygeal region with a Limberg flap plasty, as reported in countless publications, may explain the low recurrence rates.

scholarly journals Limberg flap for pilonidal sinus: an institutional study

2017 ◽  
Vol 4 (2) ◽  
pp. 496
Author(s):  
Sameer Ahmed Mulla ◽  
Srinivas Pai ◽  
Prakash Mahalingashetty
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Recurrence Rates ◽  
Duration Of Symptoms ◽  
Surgical Data ◽  
The Mean ◽  
Surgical Modality ◽  
A Prospective Study

Background: Pilonidal sinus disease is a common disorder affecting the gluteal cleft and it is notoriously recurrent. Limberg flap is a well-known surgical modality for the treatment of pilonidal sinus. This study aims at studying the surgery in a single institution.Methods: This is a prospective study of 17 limberg flaps done from 2013 to 2016. The various demographic, clinical and surgical data are studied and compared to other studies.Results: In this study, 17 patients of sacrococcygeal pilonidal disease underwent rhomboid excision and limberg flap reconstruction. The mean duration of symptoms was 6.52 months (2-13 months), and the mean operative time was 67.05 min with a range from 60 to 90 min. The mean post-operative stay was 6.05 days (3 to 10 days).Conclusions: Recurrence is known and hence surgery with flap coverage not only decreases the recurrence rates, but it also makes the stay short by eliminating daily dressing. Limberg flap is an easy and efficient way with less and manageable complication.

scholarly journals TP7.2.19 Review of bascom cleft lift and flap-procedures versus excision for pilonidal disease in a single centre (2017-2019)

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Stephen Stonelake ◽  
Pratik Bhattacharya ◽  
Christopher Thompson
Keyword(s):  
Pilonidal Disease ◽  
Surgical Techniques ◽  
Recurrence Rates ◽  
Female Ratio ◽  
Patient Demographics ◽  
Emergency Procedures ◽  
Flap Procedure ◽  
Cleft Lift ◽  
Rhomboid Flap

Abstract Introduction Pilonidal disease continues to be managed with varying surgical techniques. We review results with Bascom cleft lift comparing to other practices at our institution. Methods All elective procedures for pilonidal disease reviewed from December 2017 to December 2019. Patient demographics, previous emergency and elective procedures for pilonidal disease, follow-up, dehiscence and recurrence rates, and all-cause morbidity were examined retrospectively. Results In the study period there were 106 procedures. Average age was 27 years (range 15-64). Male to female ratio was 83:23. Procedures were excision and primary closure (48), excision and packing (19), rhomboid flap (2), Bascom cleft lift flap (31), other rotational/perforator or V to Y flaps (6). Rates of previous elective procedures in the flap procedures versus excision group were 31% and 10% respectively (P = 0.01). Rates of previous emergency procedures in the flap-procedures versus excision group were 41% and 31% respectively (P = 0.40). In 50 procedures there was a documented follow up encounter at a mean time of 55 days (median 34 days, range 2-239). Dehiscence (partial and full) in flap procedures versus excision and closure was 33% and 27% respectively (P = 0.64). Recurrence rates in flap procedures versus excision +/- closure or packing were 0% and 8% respectively (P = 0.16). Conclusion Flap procedures have a lower rate of recurrence and comparable dehiscence rates despite being performed in patients with higher rates of prior procedures for pilonidal disease. Bascom cleft lift was the simplest flap procedure most commonly performed and matches the results of more complex flaps.

scholarly journals Short-term outcomes of endoscopic pilonidal sinus treatment

2020 ◽  
Vol 102 (2) ◽  
pp. 94-97 ◽  
Author(s):  
R Kalaiselvan ◽  
ASD Liyanage ◽  
R Rajaganeshan
Keyword(s):  
Minimally Invasive ◽  
Pilonidal Sinus ◽  
Endoscopic Treatment ◽  
Pilonidal Disease ◽  
Minimally Invasive Technique ◽  
Pilonidal Sinus Disease ◽  
Invasive Technique ◽  
Short Term ◽  
Recurrence Rates

Introduction Endoscopic treatment for pilonidal disease was initially described by Meinero in 2013. This minimally invasive technique has both technical and aesthetic advantages. The diagnostic application helps identify the anatomy of the pilonidal disease and the operative phase ablates and cleans the infected cavity. Our aim was to study the short-term outcomes of endoscopic treatment for pilonidal disease and to evaluate complications and recurrence rates. Materials and methods A prospectively maintained database of all consecutive patients who underwent endoscopic treatment for pilonidal disease by a single surgeon in a district general hospital from 1 November 2014 to 31 March 2018 was analysed. Follow-up was available until 30 September 2018. Results A total of 74 patients (56 men) underwent endoscopic treatment for pilonidal disease. The median age was 21 years (range 16–62 years). All patients underwent the procedure as daycase procedures, seven under local anaesthesia. There were no immediate postoperative complications and no return to theatre or readmission within 90 days. On a median follow-up of 52 weeks (range 2–114 weeks), 57 patients healed completely and 8 lost to follow-up. We achieved primary healing rates of 67% (44/66) and delayed healing rate of 77% (51/66). Conclusions Endoscopic treatment for pilonidal disease is a safe and effective minimally invasive technique that should be considered as first-line treatment in selected cases of pilonidal sinus disease, thereby reducing morbidity related to conventional procedures.

scholarly journals Karydakis Flap: A preferred procedure for Sacrococcygeal Pilonidal Sinus Disease (SPNSD).

2020 ◽  
Vol 27 (11) ◽  
pp. 2284-2288
Author(s):  
Durr-I- Chaman ◽  
Tayyaba Fatima ◽  
Muhammad Akram ◽  
Bashir Ahmed ◽  
Sajid Rehman ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Pilonidal Sinus Disease ◽  
Average Hospital ◽  
Surgical Department ◽  
Removal Time ◽  
Drain Removal ◽  
Flap Procedure ◽  
Rate Study

Objectives: To evaluate patients with SPNSD who underwent Karydakis Flap procedure with reference to operative time, drain removal time, hospital stay, complications and recurrence rate. Study Design: Prospective study. Setting: Surgical Department of Allied Hospital, Faisalabad. Period: September 2009 to January 2018. Material & Methods: A total of 117 patients underwent Karydakis Flap procedure. Data was collected according to the above said parameters .Patients were followed up for 12 months. Results:  The operative time was 35.5 minutes. Average Hospital stay was 2 days. Drain removed at median of 8 days.17 patients (14%) developed seroma. Wound Infection occurred in 5 patients (4%). Wound burst opened in 1 patient (0.8%).No recurrence was noted (0%) in any patient during a follow up of 1 year. Conclusion: Karydakis Flap procedure is a relatively simple and easy technique with minimal chances of recurrence.

scholarly journals Z Plasty Single Center Results in The Treatment of Pilonidal Sinus Disease in Children

2020 ◽  
Vol 2 (1) ◽  
pp. 39-43
Author(s):  
Yusuf Atakan Baltrak ◽  
Seniha Esin Sogut ◽  
Onursal Varlikli
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Recurrence Rates ◽  
Sinus Disease ◽  
Common Chronic Disease ◽  
Sacrococcygeal Region ◽  
Surgical Methods

Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Treatment varies according to the clinical presentation of the disease. Although many surgical methods have proposed, the ideal approach is still lacking due to high recurrence rates. This study aimed to evaluate the role of Z-plasty in achieving primary recovery in pilonidal disease and morbidity and recurrence. Twenty-four patients (15 males and nine females) who underwent sinus excision and Z-plasty closure for the sacrococcygeal pilonidal sinus included in this study. Follow-up ranged from 6 to 12 months. There were 15 males and nine females with a median age of 16 years. The mean hospital stay was two days. There was no recurrence, and all patients were satisfied with the cosmetics. Two patients (5%) had numbness on the flap. No flap necrosis observed in any patient. Only three patients had a wound infection (7.5%). Wound seroma developed in five patients (12.5%). Although some technical expertise is required, excision of sinus and Z-plasty provides superior results in terms of recurrence and hospitalization of pilonidal sinus patients during hospitalization.

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