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Pilot Study: Application of Lateralized Z-plasty in Pilonidal Sinus Defect Closure
Changkai Zhou1, Lu Wang1, Qianqian Wang1
1From the Department of Burn and Plastic Surgery, Affiliated Hospital 2 of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China.
Plastic and Reconstructive Surgery. Global Open
|September 25, 2025
Summary
Lateralized Z-plasty (LZP) offers a promising surgical solution for pilonidal sinus (PS) by reducing wound tension. This technique demonstrated low complication rates and high patient satisfaction in a pilot study.
Area of Science:
- Surgical Innovation
- Wound Healing
- Dermatologic Surgery
Background:
- Pilonidal sinus (PS) is a chronic condition causing recurrent abscesses and significant patient impact.
- Traditional Z-plasty often fails due to inadequate management of horizontal tension, leading to high recurrence.
- This pilot study investigates a modified approach to address these limitations.
Purpose of the Study:
- To evaluate the efficacy of lateralized Z-plasty (LZP) in pilonidal sinus (PS) surgery.
- To assess LZP's ability to reduce horizontal wound tension.
- To determine the impact of LZP on postoperative outcomes, including complications and patient satisfaction.
Main Methods:
- Retrospective review of patients with sacrococcygeal PS undergoing LZP.
- A 2-stage surgical approach: sinus excision followed by LZP reconstruction.
- Flap design involved lateral limb orientation for tension reduction and transposition.
Main Results:
- 15 LZP procedures in 14 patients showed no flap necrosis, hematoma, seroma, or infection.
- Mean follow-up was 6.2 months; one delayed healing and one recurrence (managed with contralateral LZP).
- All patients reported satisfaction with postoperative appearance.
Conclusions:
- Lateralized Z-plasty (LZP) is a promising technique for pilonidal sinus (PS) treatment.
- LZP demonstrates potential for reduced complications and improved functional and aesthetic outcomes.
- Further optimization of the LZP technique may enhance its effectiveness.
