Direct midline excision and closure versus KARYDAKIS flap in treatment of sacrococcygeal pilonidal sinus

Abstract EN

Objective : Pilonidal sinus is a common surgical problem, commonly occurs in young adults with a tendency to recurrent after surgical treatment.

The objective of this study was to compare between the Karydakis flap reconstruction and the conventional midline excision closure in patients with sacrococcygeal pilonidal sinus in term of operative time, postoperative pain, complications, healing time, recurrence rate and time off work.

Results : Both groups had similar demographic and clinical presentations.

Operative time was significantly longer with the Karydakis technique (mean, 50 versus 35 minutes).

Overall, local complications rate was not significant (27.2% versus 35.1%, p>0.05), postoperative pain was significantly less with Kardakis technique (2.8 versus 5.8, p<0.05).

Time off-work was significantly shorter with Karydakis group (mean, 25 versus 30 days, p>0.05), healing time was the same in both groups (mean, 13 days).

Recurrence observed in 5 patients (13.5%) with midline closure versus, while no recurrence observed in patients with the Karydakis technique, but without statistical significance, (p=0.05).

Conclusions : Karydakis flap showed less postoperative pain, low recurrence rate and short time off work compared to midline excision closed technique.