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Karydakis flap versus excision-only technique in pilonidal disease.
Amir Keshvari1, Mohammad Reza Keramati1, Mohammad Sadegh Fazeli1
1Department of Surgery, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
The Journal of Surgical Research
|June 22, 2015
Summary
The Karydakis flap (K-flap) procedure for sacrococcygeal pilonidal disease offers faster wound healing and return to work with fewer complications and recurrences compared to excision with healing by secondary intention (EHSI).
Area of Science:
- Surgical techniques
- Colorectal surgery
- Pilonidal disease management
Background:
- Sacrococcygeal pilonidal disease is commonly managed with Karydakis flap (K-flap) or excision with healing by secondary intention (EHSI).
- Comparative outcomes of these surgical methods require further investigation.
Purpose of the Study:
- To compare the early and late outcomes of K-flap versus EHSI for sacrococcygeal pilonidal disease.
- To evaluate wound healing time, return to work, complication rates, and recurrence between the two surgical techniques.
Main Methods:
- A prospective, randomized clinical trial involving 321 patients with sacrococcygeal pilonidal disease.
- Patients were randomized to either the Karydakis procedure or excision with healing by secondary intention.
- Outcomes assessed included wound healing duration, return to work, complications, and recurrence rates.
Main Results:
- The Karydakis flap group demonstrated significantly shorter wound healing times (16.44 days vs. 80.01 days) and faster return to work (14.44 days vs. 24.19 days).
- Lower rates of wound complications (18.7% vs. 31.2%) and recurrence (1.2% vs. 7.5%) were observed in the K-flap group.
- Excision with healing by secondary intention had a significantly shorter operation time (15.87 min vs. 55.17 min).
Conclusions:
- Both Karydakis flap and excision with healing by secondary intention are safe surgical options.
- The Karydakis flap is associated with superior outcomes, including reduced complications and recurrence, and improved healing and return to work timelines.
