scholarly journals Modified Karydakis procedure for uncomplicated pilonidal sinus

2020 ◽  
Vol 7 (8) ◽  
pp. 2568
Author(s):  
Thomas George ◽  
Joe Mathew
Keyword(s):  
Pilonidal Sinus ◽  
Subcutaneous Tissue ◽  
Simple Procedure ◽  
Wound Dehiscence ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Skin Closure ◽  
Sinus Disease ◽  
Wound Discharge ◽  
One Year

Background: Pilonidal sinus disease is a chronic infection of the natal cleft commonly affecting young adults. Out of the standard operative techniques, the Karydakis procedure is a relatively simple procedure associated with low rates of wound complications and recurrence. In this study we present a modified version of the Karydakis procedure to treat less extensive disease, which enables better skin closure without cavitation and tension.Methods: Patients with uncomplicated pilonidal sinus who presented to our centre during the period from April 2015 to March 2019 were prospectively enrolled. Patients with recurrent or complex sinus disease were excluded. In those enrolled, our modified Karydakis procedure was performed. In this method, after excision a flap of skin and subcutaneous tissue was raised to one side and sutured across the midline by advancement in layers.Results: 34 patients underwent our modified Karydakis procedure. 91% (31/34) of patients had uncomplicated recovery and could return to work after two weeks. There were minimal post-operative complications, in the form of erythema around the wound (8.8%), wound discharge (5.9%), seroma (5.9%) and infection (2.9%). No patient developed wound dehiscence or flap necrosis. There were excellent cosmetic results and no recurrence at one year post-surgery.Conclusions: Our modification of the Karydakis procedure is a simple and effective surgery for the management of uncomplicated pilonidal sinus disease which achieves good results.

Pilonidal sinus disease: Karydakis flap procedure in our patients

2020 ◽  
Vol 99 (8) ◽  
Keyword(s):  
Wound Healing ◽  
Pilonidal Sinus ◽  
Healing Process ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Limberg Flap ◽  
New Disease ◽  
Sinus Disease ◽  
Flap Procedure

Introduction: Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be a frustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Methods: A total of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in a short-term follow-up period. Disease recurrence was defined as prolonged healing or as a new disease requiring repeated surgery. Results: In December 2019 all 27 patients came for a follow-up visit. The result was a fully lateralized wound without any signs of a new disease in all patients. In May 2020 a follow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. Conclusion: According to the available evidence and guidelines, off-midline procedures – the Karydakis flap, Bascom cleft lift, and Limberg flap procedures – are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in a nicely flattened gluteal crease.

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.

scholarly journals Evaluation of the use of subcutaneous drains to prevent wound complications in abdominal surgeries

2018 ◽  
Vol 5 (4) ◽  
pp. 1368
Author(s):  
G. V. Manoharan ◽  
T. Sivakumar ◽  
M. Ashok Kumar
Keyword(s):  
Hospital Stay ◽  
Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Wound Dehiscence ◽  
Wound Complications ◽  
Skin Closure ◽  
Abdominal Wall Closure ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
Group B

Background: Wound complications like surgical site infections (SSI) and wound dehiscence are common following abdominal surgery for peritonitis. Drains have been used to remove collections from the early days of surgery. The use of drains to remove subcutaneous collections to prevent wound complications needs to be studied.Methods: Sixty patients who underwent surgery for peritonitis were selected for the study. 30 patients underwent conventional abdominal wall closure while the other 30 had suction drains inserted in the subcutaneous tissue. Wounds were observed for complications and time for healing.Results: The incidence of SSI was significantly less in Group A (23%) than in Group B (60%). Similarly, wound dehiscence occurred in 43% of SSI cases in Group A as against 89% of SSI cases in Group B, the difference of which was statistically significant. The mean duration of hospital stay was significantly less when subcutaneous suction drain was placed (9 days).Conclusions: Subcutaneous suction drainage tube is an effective method of abdominal wall closure in cases of peritonitis when compared to conventional primary skin closure as it significantly reduces the incidence of SSI, wound dehiscence, wound secondary suturing and duration of hospital stay. 

scholarly journals Sinus Excision, Release of Coccycutaneous Attachments and Dermal-Subcuticular Closure (XRD Procedure): A Novel Technique in Flattening the Natal Cleft in Pilonidal Sinus Treatment

2008 ◽  
Vol 90 (5) ◽  
pp. 371-376 ◽  
Author(s):  
Deya M Marzouk ◽  
Ahmed A Abou-Zeid ◽  
Anthony Antoniou ◽  
Amyn Haji ◽  
H Benziger
Keyword(s):  
Pilonidal Sinus ◽  
Wound Dehiscence ◽  
Normal Activity ◽  
Pilonidal Sinus Disease ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Novel Technique ◽  
Before And After ◽  
A New Technique

INTRODUCTION The objective of this study was to analyse, prospectively, the outcome of a new technique – excision of pilonidal sinus and flattening the natal cleft by division of the coccycutaneous attachments at the lower end of the incision. PATIENTS AND METHODS Sixty-six consecutive patients with chronic pilonidal sinuses were treated between 1995 and 2001. The procedure consisted of an elliptical, wide, local excision, release of the coccycutaneous attachments and primary closure using dermal-subcuticular closure (XRD). Suction drains were used until drainage was minimal. The height of skin level at the lower angle of the wound from the coccyx was measured intra-operatively before and after division of the coccycutaneous attachments. Postoperatively, patients were assessed for hospital stay, return to normal activity, complications and recurrence. RESULTS Sixty-four patients (97%) were males, median age 27 years. The height of skin level rose from a mean of 1.8 cm (95% CI, 1.78–1.85) to a mean of 3.8 cm (95% CI, 3.77–3.88; P < 0.001). Morbidity affected 12 patients (18%), epidermal separation of the lower wound angles (6 patients), seromas (5 patients) and 1 wound dehiscence at 2 weeks. All other wounds healed primarily without dehiscence. There were no recurrences after a median follow-up of 22.5 months (range, 12–38 months). CONCLUSIONS Release of the coccycutaneous attachments is an easy technique to learn, which seems to be an effective way of flattening the natal cleft and may result in lower recurrence rate. This technique should be tried in uncomplicated pilonidal sinus disease before more complex procedures are attempted.

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 Pilonidal sinus disease: Preliminary case-control study on heat-related wound dehiscence

2019 ◽  
Vol 48 ◽  
pp. 144-149
Author(s):  
Frazzetta Giuseppe ◽  
Di Giovanni Silvia ◽  
Rosi Patrizia ◽  
Pertile Riccardo ◽  
Di Sipio Antonio ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Case Control Study ◽  
Wound Dehiscence ◽  
Case Control ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Control Study

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.

scholarly journals A Prospective Study of the Clinical Profile of Pilonidal Sinus Disease at a Tertiary Care Centre in North India - Comparison of Limberg Flap Closure and Z-Plasty in Treatment

2021 ◽  
Vol 8 (28) ◽  
pp. 2532-2537
Author(s):  
Gulab Dhar Yadav ◽  
Ashish Varshney ◽  
Adiveeth Deb
Keyword(s):  
Wound Healing ◽  
Pilonidal Sinus ◽  
Tertiary Care ◽  
Wound Dehiscence ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Sinus Disease ◽  
The Mean ◽  
A Prospective Study ◽  
Flap Closure

BACKGROUND Sacrococcygeal pilonidal sinus disease is defined as a hair-filled cavity in the subcutaneous fat of the natal cleft (postsacral intergluteal region). This study was done to investigate the prevalence, clinical presentation, body mass index (BMI) as a risk factor; and complications of Limberg flap and Z-plasty, for the reconstruction of defects after excision of sacrococcygeal pilonidal sinus in terms of the incidence of seroma, wound infection, wound dehiscence, flap necrosis, recurrence, duration of hospital stay and time taken for complete wound healing after the procedure. METHODS This was a prospective study done on 50 patients from January 2018 to October 2020 at a tertiary care hospital in 15 to 50 years of age group presenting with pilonidal sinus disease. Statistical analysis was done using SPSS (Statistical Package for Social Sciences) version 15.0 statistical analysis software. Significance was assessed at 5 %. RESULTS The mean age of presentation was 25 years with chief complains of swelling, discharge and pain, the mean BMI was 24.39 kg/m2 . Anaerobic infection is more common in the sinus (40 %), and among aerobic organisms, Staphylococcus was the most common organism (19 %). In Limberg flap closure, only one 1 developed wound infection and this same patient had partial wound dehiscence, while in Zplasty group, 3 developed seroma, 2 wound infections and 2 partial flap ischemia. CONCLUSIONS The goals of management of pilonidal sinus diseases include conservative management along with definitive surgical treatment of the disease. Pilonidal abscess is managed by incision and drainage and is followed by definitive treatment, later on. Flap procedures are effective ways to treat the disease, of which Limberg flap is the most reliable flap with minimum complications, lesser hospital stay and faster wound healing. KEYWORDS Pilonidal Sinus, Limberg Flap, Z-Plasty

scholarly journals S-Shaped Wide Excision with Primary Closure for Extensive Chronic Pilonidal Sinus Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Kerem Karaman ◽  
Safak Ozturk ◽  
Cem Tugmen ◽  
Eyup Kebapcı ◽  
Sait Murat Dogan ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Wide Excision ◽  
Pilonidal Sinus Disease ◽  
Natal Cleft ◽  
Sinus Disease ◽  
Postoperative Course ◽  
Large Patient ◽  
One Year ◽  
Disease Free

Background. The management of complex pilonidal sinus disease (PSD) with multiple pits on and beside the natal cleft is variable, contentious, and problematic. Wide excision of the sinus and reconstruction of the defect using different flap techniques have become more popular in recent years.Case Report. We report a case with a complex chronic PSD to which we applied primary closure after S-shaped wide excision. The patient’s postoperative course was uneventful, and at the end of one-year followup he is now disease-free and comes for routine checkups.Conclusion. The simplicity of the technique and the promising results support the applicability of the S-shaped wide excision in chronic bilaterally extended large PSDs. Further studies entailing large patient populations are needed to reach a definite conclusion.

scholarly journals PILONIDAL SINUS

2016 ◽  
Vol 23 (12) ◽  
pp. 1499-1504
Author(s):  
Muhammad Ramzan ◽  
Muhammad Khalid Mirza ◽  
Muhammad Arif Ali
Keyword(s):  
Pilonidal Sinus ◽  
Armed Forces ◽  
Pilonidal Sinus Disease ◽  
Common Symptom ◽  
Skin Closure ◽  
Duration Of Symptoms ◽  
Sinus Disease ◽  
Study Results ◽  
Study Setting ◽  
Flap Closure

Objectives: To prospectively evaluate the results of modified Karydakisprocedure with subcuticular skin closure in presacral pilonidal sinus disease patients. Design:Prospective cohort study. Setting: Armed Forces Hospital Dhahran. Period: Jan.2007 and Jan2013 were prospectively followed for 2 & ½ yrs. Methodology: 243 patients having pilonidalsinus disease who underwent surgery by modified Karydakis technique with subcuticular skinclosure. They were evaluated for age, sex, BMI, duration of symptoms, hospital stay, morbidity,recurrence and cosmetic satisfaction. The patients having acute pilonidal sinus abscess wereexcluded from the study. Results: Out of 243 patients, 230 were males and 13 females with amean age and BMI of 24.7, 26.3, 29.4 and 30.8 respectively. The most common symptom wasseropurulent discharge from the sacrococcygeal area. 232 (95.5%) patients completed theirfollow up whereas 11 (4.53%) patients (5 females and 6 males) could not be traced in follow upcalls after 3 months. 22/243 patients (9%) had minor wound related complications like minorwound infection, partial wound or skin disruption and seroma formation. There were only 3(1.23%) recurrences (2 males and 1 female). All patients were fully satisfied with the cosmeticresult. Conclusion: Karydakis asymmetrical flap closure using subcuticular skin closure is asimple technique which gives best outcome in terms of morbidity and Cosmesis.

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