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Year : 2018  |  Volume : 31  |  Issue : 1  |  Page : 102-107

Prospective randomized comparative study of a Karydakis flap versus ordinary midline closure for the treatment of primary pilonidal sinus

Department of Surgery, Faulty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Sameh M Zahran
Shakia Governorate
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.234228

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Background There is a high incidence of sacrococcygeal pilonidal disease (SPD) among young males. Despite increasing data on the treatment of SPD, no standard treatment has been established as yet. Karydakis pioneered a procedure that involved raising a flap to overlap the midline with the scar sited to one side to reduce recurrence. Objective This study evaluated the outcomes of the Karydakis flap method versus the ordinary midline closure (OMC) method for the treatment of pilonidal sinus. Patients and methods This was a prospective study that included 40 patients with SPD. They were divided into two groups according to the surgical technique used. Group I was treated by excision and closure using the transposition Karydakis flap technique at one side of the midline and group II was treated by excision and simple closure at the midline. Both groups were compared. Results The duration of the surgery was 12 min longer in the Karydakis group (P < 0.001). Complications were 50% in the OMC group compared with 25% in the Karydakis group. The recurrence rate was 5% for the Karydakis group and 20% for the OMC group. Of the patients who underwent the Karydakis operation, 70.8% were completely satisfied with the procedure, whereas only 32.6% of patients who underwent the OMC reported excellent satisfaction. A significantly higher number of patients in the Karydakis group recommended the same procedure to other patients with SPD. Conclusion The Karydakis method may be a preferable option in the treatment of SPD because of the low rate of recurrence and the excellent satisfaction rates.

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