Learning Curve for Pilonidal Sinus Surgery: The Best Option for Budding Surgeons.

Area of Science:

• Surgical outcomes
• Pilonidal sinus treatment

Background:

• Pilonidal sinus surgery lacks a gold standard, with outcomes varying by surgeon preference and experience.
• No prior studies have compared surgical outcomes for pilonidal sinus procedures performed by residents.

Purpose of the Study:

• To compare the short-term surgical outcomes of the Karydakis and Limberg flap procedures for pilonidal disease.
• To evaluate the reproducibility of these procedures by surgical residents.

Main Methods:

• A prospective, double-blinded, observational study involving 50 patients with primary pilonidal sinus openings.
• Patients underwent either the Karydakis flap (n=25) or Limberg flap (n=25) procedure.
• Exclusion criteria included frank pilonidal abscess; patients with intermittent discharge were included.

Main Results:

• The Karydakis group experienced a significantly higher infection rate (9/25) compared to the Limberg group (3/25).
• Complete wound dehiscence was also more frequent in the Karydakis group (2/25) versus the Limberg group (1/25).

Conclusions:

• The Limberg flap procedure demonstrates superiority over the Karydakis procedure for pilonidal sinus treatment.
• The Limberg flap's outcomes are reproducible by surgeons with limited experience, suggesting its efficacy for residents.