Pilonidal sinus disease: Karydakis flap procedure in our patients

Area of Science:

• Surgical procedures
• Proctology
• Wound healing

Background:

• Pilonidal sinus disease treatment remains challenging due to high recurrence and wound complication rates.
• Surgeons' opinions on optimal therapy are often ambiguous despite existing guidelines.
• The Karydakis flap procedure is an off-midline technique for pilonidal sinus disease management.

Purpose of the Study:

• To analyze the short-term outcomes of the Karydakis flap procedure in patients with pilonidal sinus disease.
• To evaluate wound healing, complication rates, and disease recurrence after Karydakis flap surgery.
• To assess the effectiveness of the Karydakis flap in achieving wound lateralization and gluteal cleft reshaping.

Main Methods:

• Prospective analysis of 27 patients with primary or recurrent pilonidal sinus disease treated with the Karydakis flap.
• Evaluation of postoperative wound healing, complications, and recurrence over a median 12-month follow-up period.
• Definition of recurrence as prolonged healing or new disease requiring re-operation.

Main Results:

• All 27 patients achieved complete wound lateralization with no signs of new disease at the initial follow-up.
• 25 out of 27 patients experienced healing free of serious complications; seromas were managed outpatient.
• Median follow-up was 12 months, indicating sustained positive outcomes.

Conclusions:

• Off-midline procedures like the Karydakis flap are associated with lower recurrence rates and improved wound healing.
• Complete wound lateralization and gluteal cleft reshaping are key to successful pilonidal sinus disease management.
• The Karydakis flap procedure demonstrates favorable short-term results for pilonidal sinus disease therapy.