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V-Y advancement flap closures for complicated pilonidal sinus disease
Huseyin Berkem1, Serdar Topaloglu, Hakan Ozel
1First Department of Surgery, Ankara Numune Training and Research Hospital, 06100, Sihhiye, Ankara, Turkey.
International Journal of Colorectal Disease
|March 5, 2005
Summary
Recurrent pilonidal sinus disease may be linked to midline suture placement. Avoiding midline sutures after V-Y advancement flap closure may reduce recurrence rates, offering a safer reconstruction method.
Area of Science:
- Surgical reconstruction
- Pilonidal sinus disease management
Background:
- The midline hair entry theory is central to pilonidal sinus formation and recurrence.
- Suture line placement relative to the midline is implicated in post-operative disease recurrence.
Purpose of the Study:
- To evaluate the relationship between suture line placement and midline in V-Y advancement flap closure for pilonidal sinus disease.
- To assess the impact of suture line position on recurrence rates.
Main Methods:
- A randomized study of 34 patients with stage 4 or recurrent pilonidal sinus disease undergoing V-Y advancement flap closure.
- Patients were divided into two groups: vertical suture line unrelated to midline (VLUM) and vertical suture line related to midline (VLRM).
Main Results:
- No flap necrosis, hematomas, or seromas were observed in either group.
- The median hospital stay was 3 days for both groups.
- Two recurrences occurred in the midline-related suture group (VLRM) within 22 months, located in midline scar tissue.
Conclusions:
- Suction drains are not routinely recommended after V-Y advancement flap closure.
- Avoiding midline suture placement in V-Y advancement flap closure is a safe and effective method for definitive reconstruction, potentially reducing recurrence.