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Pilonidal sinus: experience with the Karydakis flap

P R Kitchen1

  • 1Department of Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia.

The British Journal of Surgery
|October 1, 1996
PubMed
Summary

The Karydakis operation effectively treats postanal pilonidal sinus with a low recurrence rate. This surgical technique lateralizes the suture line, reducing the risk of hair penetration and subsequent sinus formation.

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology

Background:

  • Postanal pilonidal sinus is a chronic condition often requiring surgical intervention.
  • Recurrence and healing complications are significant challenges in managing this condition.

Purpose of the Study:

  • To evaluate the efficacy and recurrence rates of the Karydakis operation for postanal pilonidal sinus.
  • To assess the success of the Karydakis operation in patients with prior treatment failures.

Main Methods:

  • A personal series of 141 patients with postanal pilonidal sinus underwent the Karydakis operation.
  • Surgical technique involved total excision of the sinus with an eccentric elliptical excision and flap advancement.
  • Follow-up was conducted for 1-108 months in 114 patients.

Main Results:

  • An overall recurrence rate of 4% (5 patients) was observed, requiring further surgery.
  • Of 33 referred patients with previous treatment failures, all were successfully cured.
  • Long-term follow-up (over 18 months) was achieved in 69% of patients.

Conclusions:

  • The Karydakis operation demonstrates a low recurrence rate for postanal pilonidal sinus.
  • The technique's success is attributed to creating a shallow, lateralized midline wound less prone to hair penetration.
  • This method offers a high cure rate, even in previously treated or failed cases.

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