Related Experiment Videos
Pilonidal sinus: experience with the Karydakis flap
1Department of Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia.
Abstract:
A personal series of 141 patients with postanal pilonidal sinus was treated by the Karydakis operation. Each sinus was totally excised with a vertical eccentric elliptical excision. A thick flap was created by undercutting the medial edge and advancing it across the midline so that the whole suture line was lateralized to reduce the risk of recurrence. Follow-up was achieved in 114 patients for 1-108 months; 79 (69 per cent) were followed for more than 18 months. Overall there were five recurrences (4 per cent) which required further surgery. Thirty-three patients (23 per cent) were referred following recurrence or failure of healing after previous surgery elsewhere; all were cured by this method. The Karydakis operation has a low recurrence rate because it produces a shallow midline furrow free from scar or suture holes which is less vulnerable to hair penetration than a midline wound.
Insights
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.
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.