Are postoperative drains necessary with the Karydakis flap for treatment of pilonidal sinus? (Can fibrin glue be replaced to drains?) A prospective randomized trial

Sözen, Selim; Emir, Seyfi; Güzel, Kerim; Özdemir, Cengizhan Şan

doi:10.1007/s11845-010-0549-4

Cited by 20 publications

(5 citation statements)

References 12 publications

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“…The failure rate of primary healing was 16%, the length of hospitalization averaged 21.7 days, and the recurrence rate was 16%. Several flap techniques have been described with recurrence rates ranging between zero and 6-8% 6-8,10-13 .…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease

Bali

Aziret

Sözen

et al. 2015

Clinics

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OBJECTIVE:Sacrococcygeal pilonidal sinus is common in young men and may recur over time after surgery. We investigated whether a factor exists that can aid in the determination of the preferred technique between the early Limberg flap and Karydakis flap techniques for treating recurrent pilonidal sinus.MATERIALS AND METHODS:This prospective and randomized study enrolled 71 patients with recurrent pilonidal sinus in whom the Limberg flap or Karydakis flap techniques were applied for reconstruction after excision. Patients were divided into two groups as follows: 37 patients were treated with the Limberg flap technique and 34 patients were treated with the Karydakis flap technique. Fluid collection, wound infection, flap edema, hematoma, partial wound separation, return to daily activities, pain score, complete healing time, painless seating and patient satisfaction were compared between the groups. ClinicalTrial.gov: NCT02287935.RESULTS:The development rates of total fluid collection, wound infection, flap edema, hematoma, and partial wound separation were 9.8%, 16%, 7%, 15% and 4.2%, respectively; total flap necrosis was not observed in any patient (p<0.001). During the average follow-up of 28 months, no patients (0%) developed recurrent disease. The two groups differed with respect to early surgical complications (p<0.001).CONCLUSION:In this study, use of the Limberg flap was associated with lower complication rates, shorter length of hospital stay, early return to work, low pain score, high patient satisfaction and better complete healing duration. Therefore, we recommend the Limberg flap for treatment of recurrent pilonidal sinus.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease

Bali

Aziret

Sözen

et al. 2015

Clinics

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“…The main goal of treatment of the sacrococcygeal pilonidal sinus disease is the selection of the most appropriate technique that causes the least number of early postoperative complications, shortens the length of hospital stay, and results in the least number of long-term recurrences [7]. Numerous methods have been described as surgical treatment alternatives for sacrococcygeal pilonidal sinus disease, including primary oblique excision and closure, marsupialization, secondary healing, V-Y advancement flap, Z-plasty, Limberg flap, and Karydakis flap techniques [8, 9]. …”

Section: Discussionmentioning

confidence: 99%

Karydakis Flap Procedure in Patients with Sacrococcygeal Pilonidal Sinus Disease: Experience of a Single Centre in Istanbul

Yıldız

Özkan

Odabaşı

et al. 2013

The Scientific World Journal

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Background. The aim of this retrospective study was to evaluate the results of patients with sacrococcygeal pilonidal sinus who underwent surgery using the Karydakis technique. Methods. Two hundred fifty-seven patients with sacrococcygeal pilonidal sinus disease were treated by the Karydakis flap procedure between December 2003 and June 2011. Patients were evaluated with respect to age, gender, preoperative symptoms, duration of preoperative symptoms, history of pilonidal sinus surgery, early postoperative complications, recurrence rates, and cosmetic satisfaction. Results. There were 223 (86.8%) male and 34 (13.2%) female patients. The mean age of the patients was 27.15 ± 7.69 years. The most frequent symptom was seropurulent discharge (57.58%). Postoperative morbidity was noted in 24 patients (9.3%). The mean hospital length of stay was 3.34 ± 1.42 days. The cosmetic satisfaction rate was 91.06%. Recurrences were noted in 6 patients (2.3%). Conclusion. The Karydakis flap procedure is a safe treatment alternative for the surgical treatment of sacrococcygeal pilonidal sinus disease owing to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.

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“…at riskRR in % (95% CI)Nr. at riskPrimary open (143)2.7* (0.0–5.5)143*5.9* (1.4–10.4)120*NANANANA 32, 114, 118 Primary median closure (2902)0.8 (0.4–1.1)28187.0* (5.7–8.2)1383*18.8* (15.7–21.8)417*NANA 118, 127, 133, 136, 137, 139, 143, 148, 149, 158– 160, 169, 172– 174, 183, 192, 199– 201, 232, 242, 243, 246, 247, 597– 603 Primary asymmetric closure (727)1.7 (0.7–2.8)6212.5 (1.1–3.8)4037.4 (4.4–10.4)257NANA 183, 192, 253, 259, 261, 262 Karydakis/Bascom (2471)0.8 (0.4–1.1)23561.7* (1.1–2.4)1343*10.7 (7.4–13.9)257NANA 133, 172, 192, 199, 200, 262, 264, 267, 268, 270, 273, 274, 276, 279, 282, 284, 289– 292, 295, 296, 300, 305– 309, 603 Limberg/Dufourmentel (7653)0.1 (0.0–0.2)73691.1 (0.8–1.4)…”

Section: Resultsmentioning

confidence: 99%

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

Doll

Orlik

Maier

et al. 2019

Sci Rep

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Pilonidal sinus disease (PSD) is increasing globally. A recent meta-analysis and merged-data analysis showed that recurrence rates in PSD depend essentially on follow-up time and specific surgical procedures. However, the global distribution of surgical approaches and respective recurrence rates have never been studied in PSD. We aimed at studying the impact of geographic distribution of surgical approaches to treat PSD and subsequent geography-specific recurrence rates. We searched relevant databases as described previously. Recurrence rates were then associated with reported follow-up times and geographic origin. We simulated individual patients to enable analogy across data. Globally, recurrence rates range from 0.3% for Limberg/Dufourmentel approaches (95% CI 0.2–0.4) and flaps (95% CI 0.1–0.5) and up to 6.3% for incision (95% CI 3.2–9.3) at 12 months. Recurrence rates range from 0.3% for Karydakis/Bascom approaches (95% CI 0.0–0.8) up to 67.2% for incision (95% CI 7.5–100) in the USA, and 0.0% for primary asymmetric closure in Germany (95% CI 0.0–0.0). Our analysis shows that recurrence rates in PSD not only depend on therapeutic approaches and follow-up time but also on geography. Primary asymmetric closure and various flap techniques remain superior regardless of the geographical region. Some approaches have extraordinarily good outcomes in specific countries.

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Are postoperative drains necessary with the Karydakis flap for treatment of pilonidal sinus? (Can fibrin glue be replaced to drains?) A prospective randomized trial

Abstract: We recommend the use of fibrin sealant with Karydakis flap procedure, but further studies are needed to confirm this conclusion.

Cited by 20 publications

References 12 publications

Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease

Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease

Karydakis Flap Procedure in Patients with Sacrococcygeal Pilonidal Sinus Disease: Experience of a Single Centre in Istanbul

Impact of geography and surgical approach on recurrence in global pilonidal sinus disease

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