S-plasty for pilonidal disease: modified primary closure reducing tension

Abstract

PurposeS-plasty for pilonidal disease reduces the tension on the midline by distributing it diagonally and flattening the natal cleft. The aim of this study was to evaluate the outcomes of S-plasty on simple midline primary closure and the clinical features of pilonidal patients in a low incidence country.MethodsS-plasty was applied on 17 patients from July 2008 to October 2010. Data of these patients were collected with computerized prospective database forms during a perioperative period and via telephone interview for follow-up. Surgical site infection (SSI) was defined according to the Center for Disease Control guidelines. The severity of surgical site infection was graded.ResultsAll patients were treated with primary S-plasty. Two patients (11.7%) developed low grade SSI. The average healing time after S-plasty was 18.1 days. No recurrences were observed. The mean follow-up period was 13.5 months (range, 6 to 33 months).ConclusionWe have shown that primary S-plasty for pilonidal disease is simple, and its surgical outcomes are compatible to the results of other surgical treatments. We present primary S-plasty as a feasible treatment option in a low incidence country.

Pilonidal Disease- Review Article

“…[21] It flattens the intergluteal sulcus and diverts the incision scar from the midline. [ Figure 07] [21] S-type oblique excision Recently, the S-type oblique excision for pilonidal sinus was described, and bilateral advancement of the gluteus maximus fascia in addition to primary repair with this excision has been described as a flap reconstruction technique [27,76] . The S-type excision can be used only in lesions smaller than 3 cm with a full-thickness flap as described by Krand et al [27] .…”

Specimen index may be a predictive factor for recurrence after primary closure of pilonidal disease

“…In this study the incidence of recurrence was similar between the two groups [25]. The results of this study showed that recurrence is higher in patient with high VS regardless of the operation method as large volumes of tissue excised resulted in a greater recurrence rate.…”

The Evaluation of a Modified Dufourmentel Flap after S‐Type Excision for Pilonidal Sinus Disease

“…Despite its higher rate of recurrence compared to marsupialization, primary closure postexcision was generally preferred because of its shorter healing time and better patient comfort [9]. Recent studies have shown that the excision used in primary closure affects the recurrence levels [10, 11]. Recurrence is affected by a deep intergluteal sulcus, the effect of vacuum developing between the buttocks, and a midline incision scar [12].…”

“…Recently, the S-type oblique excision for pilonidal sinus was described, and bilateral advancement of the gluteus maximus fascia in addition to primary repair with this excision has been described as a flap reconstruction technique [4, 11]. Krand et al performed tension-free repair in limited lesions using this technique and reported total complication and recurrence levels of 7.2% and 0.7%, respectively, in a series of 278 patients [4].…”