Management of Pilonidal Sinus Disease With Oblique Excision and Primary Closure: Results of 493 Patients

Menteş, Öner; Bağcı, Mahir; Bilgin, Turker; Coşkun, İbrahim; Özgül, Ömer; Özdemir, Mustafa

doi:10.1007/s10350-005-0226-2

Cited by 64 publications

(64 citation statements)

References 21 publications

(15 reference statements)

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“…The diameter and the number of the sinus tracts, volume of the excision material are also found to be important parameters for recurrence even if an R₀ resection was obtained (19,20).…”

Section: Discussionmentioning

confidence: 99%

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Uçar¹,

Cartı²,

Oymacı³

et al. 2016

UCD

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Objective: Pilonidal sinus disease (PSD) effects mainly young men's social and work life with frequent recurrence rate. Reoperation for unimproved or recurrent disease is somehow troublesome. Surgeons may think that changing treatment strategy after recurrence may prevent further relapses of PSD. We analyzed patients with recurrent pilonidal sinus to determine their predisposing features for recurrence and the outcomes of the preferred surgical methods. Material and Methods:From 2007 to 2012, out of 95 recurrent pilonidal sinus disease (rPSD) patients, 62 operated cases were included and examined retrospectively. Their retrospective data were examined for demographics, 1 st and 2 nd operation types, patient satisfaction and pain scores. For cases with insufficient preoperative or postoperative data, phone call and interviews were done to obtain data. Some were kindly invited to the outpatient examination. Student's t test, Mann-Whitney U test, and Kaplan Meier test for disease free survival time were used where appropriate. P values less than 0.05 were accepted to be statistically significant. Results:Total of 62 rPSD patients were examined. Male:female ratio was 2.9:1. The mean age after 1 st and 2 nd operations were 24.7 and 28.1 years, respectively. One and five-year recurrence rates were 33.9% and 66.1%, respectively. The mean interval between the 1 st and 2 nd operations was 45.6 months. Excision and midline closure was the most frequent type of operation followed by flap reconstructions and excision-lay open procedures. The 1 st operation types of rPSD cases were different from that of 2 nd operations. Pain perception and satisfaction scores were better in flap reconstruction groups. Conclusion:Reoperative surgery of rPSD is satisfactory with certain precautions. Relapses after flap reconstruction procedures with a well-being period should be referred as second primary disease. Changing surgical strategy is not always indicated as some patients with recurrence have relapsing or second primary disease that have distinct clinical course. Re-flap surgery after any kind of relapse is well appreciated.

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“…The diameter and the number of the sinus tracts, volume of the excision material are also found to be important parameters for recurrence even if an R₀ resection was obtained (19,20).…”

Section: Discussionmentioning

confidence: 99%

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Uçar¹,

Cartı²,

Oymacı³

et al. 2016

UCD

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“…Nevertheless, it is noteworthy to mention that healing time of the patients who received marsupialization lasts up to 4 to 5 weeks, and a significant number of wound dressings is required as a result. 15 The disadvantage led the surgeons to quit the practice of leaving the wound open, and adopt operations such as excision þ primary repair. These operations are known to ensure shorter return-towork time and quick-healing compared with marsupialization, yet it is reported that they have high complication rates (wound disintegration, infection, pain).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Modified Limberg Flap and Karydakis Flap Operations in Pilonidal Sinus Surgery: Prospective Randomized Study

Tokaç¹,

Dumlu²,

Aydın³

et al. 2015

International Surgery

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The best surgical technique for pilonidal sinus disease (PSD) is still disputed. The objective of this prospective randomized study is to compare the short and long-term results of modified Limberg flap and Karydakis flap surgeries that have been widely used in recent years. Ninety one patients were included in the study. The patients were divided into two groups: modified Limberg flap (MLF; n ¼ 46) and Karydakis flap (KF; n ¼ 45). Preoperative findings of the patients, their surgical findings, and short and long-term postoperative findings were recorded and statistically compared. While no significant difference was discovered between the groups in terms of postoperative analgesic need, hospital stay, postoperative infection rate, drain stay time, painless sitting time, painless toilet-sitting time, and painless walking time, return to work or school time was shorter in the MLF group compared with the KF group (20.61 6 7.89 days, 23.29 6 6.42, respectively; P , 0.05). Cosmetically, the visual analog scale (VAS) of the KF group was significantly higher than that of the MLF group (VAS score 7.12 6 1.28, 5.45 6 1.77, respectively; P , 0.05). Considering recurrence rates, no statistically significant difference was found between the groups. Our study found out that short and longterm results of the MLF and KF procedures are similar. We believe both methods can be safely used in surgical PSD treatment given that in the MLF procedure, shorter return-towork time is achieved, while the procedure provides better cosmetic results.

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“…In order to avoid median recurrences and flatten the natal cleft, surgeons have developed numerous procedures such as the Karydakis technique (3,16,17), Bascom procedure (18,19,20,21) and other asymmetrical closing techniques (22,23) such as rhomboid excision with Limberg (24,25,26,27) or Dufourmentel flap closure (28), z-plasty (29) or rotation flap (30). In general, results of these asymmetrical closure and flap techniques seem better than results of open technique or primary midline closure techniques, although the surgical trauma is more extensive, and cosmetic results are not always optimal.…”

Section: Introductionmentioning

confidence: 99%

Secondary Healing versus Midline Closure and Modified Bascom Natal Cleft Lift for Pilonidal Sinus Disease

et al. 2011

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Background and Aims: pilonidal sinus disease is a common disease in young employed male adults. ongoing discomfort usually indicates an operative intervention. the main drawback is however the complication of wound healing. numerous techniques for surgical treatment have been proposed, which underlies the lack of a superior technique.Material and Methods: a retrospective study was performed on the medical notes of 62 patients operated for a pilonidal sinus between may 2005 and december 2006. used techniques were: 'modified Bascom procedure', 'excision and primary closure' and 'excision with secondary wound healing'. patients' characteristics, operative parameters and data on outcome were included. the primary endpoint was wound healing.Results: twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. there were no demographical differences between the groups of patients. the modified Bascom technique showed a significantly reduced wound healing time (29 days) compared to primary closure (52 days, p < 0.01) and secondary healing (62 days, p < 0.01). the duration of this modified procedure was significantly longer (49, 33 and 24 minutes respectively, p < 0.01).Conclusions: Wound healing remains an important problem in the surgical treatment of pilonidal disease. Significant faster convalescence can be achieved using the modified Bascom procedure. Wide local excision as primary therapy should not be advocated.

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Management of Pilonidal Sinus Disease With Oblique Excision and Primary Closure: Results of 493 Patients

Abstract: The ideal operation for pilonidal sinus disease treatment must be simple and effective. The technique of oblique excision and primary closure may be considered an alternative operation for pilonidal sinus resulting in a low recurrence rate.

Cited by 64 publications

References 21 publications

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Comparison of Modified Limberg Flap and Karydakis Flap Operations in Pilonidal Sinus Surgery: Prospective Randomized Study

Secondary Healing versus Midline Closure and Modified Bascom Natal Cleft Lift for Pilonidal Sinus Disease

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