Modified elliptical rotation flap for sacrococcygeal pilonidal sinus disease

Although various surgical procedures have been described for pilonidal sinus disease, the best surgical technique is still controversial. The aim of this study was to evaluate the short-term results of modified elliptical rotation flap (MERF) for pilonidal sinus disease in terms of post-operative complications, recurrence and quality of life.

Data of 121 patients (10 women, 111 men) who were operated on for sacrococcygeal pilonidal sinus disease between 2011 and 2013 were analysed. Elliptical rotation flap procedure which was described by Nessar et al. was modified. Complications, quality of life and recurrence were evaluated.

The mean operating time was 31 (range, 20-55) min. The mean time for complete healing was 2.26±0.72 weeks. The mean time for returning to daily activities was 9.0±2.2 days. There were no flap necrosis and recurrence. Post-operative infection developed in five (4.1%) patients, which was managed by removal of a few skin sutures, drainage and prolonged antibiotic use. Four patients (3.3%) developed a seroma, three of them having a partial wound dehiscence (2.5%). Neither haematoma formation nor complete dehiscence were observed.

MERF seems to be an effective and reliable procedure having low morbidity rates and no recurrence. Further prospective randomized studies comparing the MERF with other flap techniques will provide better information about the technique.