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 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 Limberg Flap Reconstruction in Treating Sacrococcygeal Pilonidal Sinus

2019 ◽  
Vol 19 (1) ◽  
pp. 105-109
Author(s):  
Md Omar Faruk ◽  
Md Shahadot Hossain Sheikh ◽  
Mst Maksuda Parvin ◽  
Muhammad Ali Siddiquee ◽  
Md Jahangir Hossain Bhuiyan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Medical Science ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Reliable Technique ◽  
Sinus Disease ◽  
The Mean

Background: Pilonidal sinus is the relatively common condition affecting men almost twice as often as the women we experienced. The estimated incidence is 0.26 per thousand populations in general. The management of pilonidal sinus disease remains controversial, and gold standard treatment modality has yet to be established. Limberg procedure is a safe and reliable technique in the treatment of the sacrococcygeal pilonidal sinus disease, with a low complication and recurrence rates if performed according to the appropriate surgical principles. Methods: This is a Prospective study on 24 patients between the period from July 2014 to Dec 2018 in the Department of Surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU) as well as other different hospitals in Dhaka, Bangladesh. The patients having primary or recurrent pilonidal sinus disease underwent the foresaid surgical treatment. Results: Twenty four patients underwent this operation. Among them, the picture was that 20(83.3%) were males and 4(16.7%) were female. The mean age was 31, (Range: 17-45 years). 6(25%) patients were presented with recurrent sinus and 5 of them had one or more occasion previous surgery. Twenty one patients (87.5%) had full primary healing without any complication. But 1(4.2%) patient had minimal sarcoma, 1(4.2%) patient had superficial infection and the remaining other 1(4.2%) had partial flap necrosis. However, all three healed completely with conservative treatment. The mean length of hospital stay was 2.45 (Range: 1-5) days and the most patients returned to their work within 3 weeks. Conclusion: Limberg flap is very effective for sacrococcygeal pilonidal sinus disease with low complication rates, shorter hospital stay, low recurrence rates, earlier healing and reduced off-work period. The surgery can be easily mastered. We recommend Limberg flap as preferred surgery in the cases of Sacrococcygeal Pilonidal sinus. Bangladesh Journal of Medical Science Vol.19(1) 2020 p.105-109

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.

Surgical reconstruction of pilonidal sinus disease with concomitant extracellular matrix graft placement: a case series

2021 ◽  
Vol 30 (Sup7) ◽  
pp. S28-S34
Author(s):  
Abigail E Chaffin ◽  
Shane G Dowling ◽  
Mychajlo S Kosyk ◽  
Brandon A Bosque
Keyword(s):  
Extracellular Matrix ◽  
Postoperative Complications ◽  
Pilonidal Sinus ◽  
Case Series ◽  
Surgical Reconstruction ◽  
Pilonidal Sinus Disease ◽  
Surgical Approaches ◽  
Flap Reconstruction ◽  
Recurrence Rates ◽  
Sinus Disease

Background: Pilonidal sinus disease (PSD) is a chronic inflammatory disease affecting the soft tissue of the sacrococcygeal region and remains a challenging disease for clinicians to treat. The optimal treatment for PSD remains controversial and recent reports describe several different surgical approaches offering different benefits. Approximately 40% of initial incision and drainage cases require subsequent surgery. Due to high recurrence rates and postoperative complications, a more complex revision surgery involving a flap reconstruction may be required. We hypothesised that the combination of an extracellular matrix (ECM) graft with tissue flap reconstruction may decrease the postoperative complications and recurrence rates for PSD. Method: We report a retrospective case series using a surgical flap reconstruction with concomitant implantation of an ovine forestomach ECM graft under a fasciocutaneous flap with an off-midline closure for recurrent PSD, where previously surgical intervention had failed due to wound dehiscence and/or recurrent disease. Results: The case series included six patients. After three weeks, all patients except one were fully healed, and the sixth was fully healed by week 4; all wounds remained fully healed at 12 weeks. All patients achieved good cosmesis and were able to return to normal function without any residual symptoms. Conclusion: This pilot case series explored augmenting a flap reconstruction for complex PSD with advanced ECM graft materials, demonstrating that it may improve outcomes and minimise typical complications seen in flap closure, such as inflammation, infection, haematoma/seroma and hypoperfusion. Although the study had a limited number of participants, long-term outcomes were promising and suggest that further studies are warranted.

scholarly journals Karydakis Flap Procedure in Patients with Sacrococcygeal Pilonidal Sinus Disease: Experience of a Single Centre in Istanbul

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Kamil Yildiz ◽  
Erkan Ozkan ◽  
Hacı Mehmet Odabaşı ◽  
Bülent Kaya ◽  
Cengiz Eriş ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Pilonidal Sinus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Satisfaction Rate ◽  
Flap Procedure ◽  
The Mean

Background. The aim of this retrospective study was to evaluate the results of patients with sacrococcygeal pilonidal sinus who underwent surgery using the Karydakis technique.Methods. Two hundred fifty-seven patients with sacrococcygeal pilonidal sinus disease were treated by the Karydakis flap procedure between December 2003 and June 2011. Patients were evaluated with respect to age, gender, preoperative symptoms, duration of preoperative symptoms, history of pilonidal sinus surgery, early postoperative complications, recurrence rates, and cosmetic satisfaction.Results. There were 223 (86.8%) male and 34 (13.2%) female patients. The mean age of the patients was years. The most frequent symptom was seropurulent discharge (57.58%). Postoperative morbidity was noted in 24 patients (9.3%). The mean hospital length of stay was days. The cosmetic satisfaction rate was 91.06%. Recurrences were noted in 6 patients (2.3%).Conclusion. The Karydakis flap procedure is a safe treatment alternative for the surgical treatment of sacrococcygeal pilonidal sinus disease owing to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.

Sacrococcygeal pilonidal sinus disease with Limberg flap repair

2002 ◽  
Vol 6 (1) ◽  
pp. 27-32 ◽  
Author(s):  
M. Kapan ◽  
S. Kapan ◽  
S. Pekmezci ◽  
V. Durgun
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Flap Repair

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 Recurrence rates after uncommon surgical procedures for pilonidal sinus disease

2019 ◽  
Vol 41 (2) ◽  
pp. 96-100
Author(s):  
T. Baur ◽  
V. K. Stauffer ◽  
A. P. Vogt ◽  
P. Kauf ◽  
M. Schmid ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Recurrence Rates ◽  
Sinus Disease

scholarly journals Modified Limberg flap versus modified Karydakis flap in pilonidal sinus disease: single surgeon experience

2019 ◽  
Vol 6 (9) ◽  
pp. 3069
Author(s):  
Umit Turan
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Complication Rates ◽  
Sinus Disease ◽  
Surgeon Experience ◽  
Modified Limberg Flap

Background: The aim of this study was to analyze and compare the results of the modified Limberg flap (MLF) and modified Karydakis flap (MKF) techniques which were performed for the treatment of pilonidal sinus disease (PSD).Methods: The patients who were operated for PSD by the same surgeon between November 2010 and July 2013 in Konya Seydisehir Hospital were retrospectively analyzed. A total of 106 patients were evaluated in this study regarding age, gender, operation time, length of hospital stay, and postoperative complications.Results: There were 14 female and 92 male patients (MLF; 5/52 and MKF; 9/40). MLF was performed in 57 (53.8%) patients and MKF was performed in 49 (46.2%) patients. Length of Hospital stay and drain removal time were less in MKF group but it was not significantly different between two groups (p>0.05). Operation time was shorter in MKF group than MLF group (p<0.05). The complication rates of the MLF and MKF groups were 10.5% and 12.2% respectively. The recurrence was seen in 1 patient in MLF group and 2 in MKF group.Conclusions: MKF has shorter operation time than MLF, however both techniques have a similar complication and recurrence rate. In conclusion MLF and MKF procedures can be safely used as a surgical treatment of PSD.

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