"Flag Excision and Flap" Procedure: a Novel Modification for Off-Midline Closure After Pilonidal Sinus Excision

Area of Science:

• Surgical Innovation
• Pilonidal Sinus Treatment
• Wound Healing

Background:

• Pilonidal sinus surgery has advanced with flap techniques.
• Off-midline closure is preferred for faster recovery and reduced recurrence.
• Existing methods may lead to maceration or wound complications.

Purpose of the Study:

• To introduce a modified rhomboid excision and flap reconstruction technique.
• To evaluate the efficacy and safety of this novel flag modification.
• To assess outcomes in patients undergoing this procedure.

Main Methods:

• A modified rhomboid excision and flap reconstruction technique (flag excision) was employed.
• 100 patients were treated between December 2007 and June 2009.
• Patients were followed for a mean of 42 months post-surgery under regional anesthesia.

Main Results:

• Successful closure was achieved in all patients without midline overlap.
• No seroma complications were reported.
• A low complication rate of 2% for partial wound detachment and 0% recurrence was observed.

Conclusions:

• The flag excision and flap reconstruction technique is effective for pilonidal sinus.
• This method ensures comfortable, quick healing with minimal complications.
• It provides a viable alternative for off-midline closure without maceration.