269 Outcomes of Modified Karydakis Flap in The Surgical Management of Sacrococcygeal Pilonidal Disease: A Single Surgeon’s Experience

Abstract

Aim To determine the incidence of post-operative complications of patients with sacrococcygeal pilonidal disease who were treated with the Modified Karydakis flap with a specific management bundle. Primary outcomes assessed included the post-operative incidence of seroma, haematoma, SSI, deep SSI, wound dehiscence, re-admissions, return to theatre and flap necrosis. Secondary outcome evaluated was recurrence at 6 months follow up. Method It was a retrospective analysis of a single surgeon’s (FA’s) practice results of Modified Karydakis flaps on patients with sacrococcygeal pilonidal disease who were managed according to a specific protocol (fig. 1). Data was collected between June 2017 and June 2020. 96 patients were analysed, of which 9 were excluded as they only had excision without closure. Pre, per and post-operative management of the remaining 87 patients was according to a standardised protocol (fig. 1). Data was collected from patient’s notes and from prospectively and retrospectively maintained patient data bases (Theatre System, Medway). Results Primary outcomes: Secondary outcome: Conclusions Good surgical results can be obtained with Modified Karadakis flap, provided meticulous surgical technique is applied. Placement of a suction drain for a minimum of 72 hours reduces incidence of post-operative haematoma and seroma formation. Three post-operative doses of broad-spectrum intravenous antibiotics followed by 5 days of oral antibiotics helps reduce post-operative infections.

Surgical Outcome of Modified Karydakis Flap and Modified Limberg Flab in the Management of Sacroccygeal Pilonidal Disease: A Comparative Study

“…Caliskan et al 18 published that no significant statistical difference in recurrence rates was found and the overall recurrence rate was 4.7%. Alam et al 20 published in their study that the secondary outcome of MKF recurrence at the 6-month follow-up was 2/87 (2.3%).…”

“…Khan et al 19 had proven that, in terms of early outcomes, MLFG was significantly better than MKF regarding wound site infection and seroma development. Alam et al 20 published in their primary analysis outcomes the following results: seroma formation 8/87 (9.2%), hematoma formation 1/87 (1.2%), superficial wound dehiscence 7/87 (8.0%).…”

“…The MKF and MLF procedures have shown to be effective and can be safely used as a treatment of SPD and can both be performed as day-case surgeries, according to Turan, 17 Bessa et al, 15 and Alam et al, 20 who reported good promising surgical outcomes with MKF operations with careful surgical technique as it offers a significantly reduced operating time, less wound dehiscence, and a higher rate of patient cosmetics satisfaction.…”