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Updated: Jan 21, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Asymmetric sinus excision and primary closure with additional skin excision technique. Effect of reduction of
Objective:
Pilonidal sinus is one of the common diseases, although there is still no gold standard of treatment available. The aim of this study was to reduce the residual dead-space volume with a modification following the standard Karydakis procedure.
Methods:
A total of 100 patients were included in a randomised controlled trial, who were divided into two groups. Each group included 50 patients, and the patients in Group-1 were treated with the new technique, whereas in Group- 2, the standard Karydakis technique was performed. In the new technique, following total sinus excision, an advancement tissue flap was performed using additional skin excision, in order to reduce the dead-space volume.
Results:
There was no significant difference in terms of sex, age, and sinus volume. Operation time was longer in first group (p=0,002). Seroma formation rate was higher in the secound group (p=0.036). There was no significant difference in terms of soft tissue infection (p=0.339) and wound dehiscence (p=0.218). The mean follow-up period was 30 months and no recurrence was observed in both groups.
Conclusions:
The results of the study suggest that this technique may be considered as an alternative surgical method in pilonidal sinus surgery.
Key Words:
Dead, Karydakis flap-space volume, Sacrococcygeal pilonidal sinus, Seroma, Skin excision.
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