V-Y Advancement Flap Technique in Resurfacing Postexcisional Defect in Cases with Pilonidal Sinus Disease—Study of 25 Cases

Abstract

We report our experience of technique of V-Yplasty in treatment of pilonidal sinus. A retrospective study of 25 patients performed from 2005 to 2010 at Deenanath Mangeshkar Hospital and Sassoon General Hospitals, Pune, was performed. The unilateral or bilateral V-Y advancement flap technique was used in the management of these patients. The outcome was assessed on the basis of efficacy of flap surgery in achieving wound healing and recurrence. The follow-up ranged from 6 months to 5 years. The study included 25 cases of pilonidal sinus. Nineteen patients (76%) underwent unilateral V-Y-plasty and six patients (24%) underwent bilateral V-Y-plasty. Eighty-four percent cases were from the age group of 21-30 years. Sixty-eight percent patients were mobilized on the fourth postoperative day and 32% patients were mobilized on the third postoperative day. No recurrence was found in any of the patients. Itching and hypertrophic scar were found in two cases (8%), and decreased sensation was found in one patient (4%). The V-Y advancement flap technique for the treatment of pilonidal sinus is efficient and can reduce recurrence. Unilateral/ bilateral V-Y flap achieves suture line away from midline, obliteration of natal fold and coverage of defect without tension. In follow-up none of the patients showed recurrence. This technique has distinctly less morbidity and avoids of multiple dressings, reducing the total cost of the treatment. V-Y advancement flap is distinctly better choice among the available flaps as it is less time-consuming, requires less technical expertise as compared to Z-plasty and perforator flaps, and is reliable and easy to plan.

Comparison of surgical Limberg flap technique and crystallized phenol application in the treatment of pilonidal sinus disease: a retrospective study

“…Treatment of pilonidal sinus disease contains many different techniques from simple drainage to complicated flaps (8)(9)(10)13). The treatment may vary with the disease condition and the surgeon's experience.…”

“…Although there are many different opinions regarding the surgical treatment of pilonidal sinus disease in the literature, the common issues are that surgery should be simple and easily applicable, that the hospital length of stay should be short, with less postoperative wound care and pain, low recurrence rates and short period to return to daily activities (4)(5)(6). That is why various surgical techniques like sinotomy, marsupialization, Karydakis, oblique primary repair and flap techniques have been applied and compared for many years (7)(8)(9)(10)(11).…”

Comparación Entre El Colgajo De Limberg Y El Colgajo De Karydakis en El Tratamiento De La Enfermedad Del Seno Pilonidal

“…Durante el siglo pasado se asentó el concepto que el mejor tratamiento es la resección y el cierre inmediato; se debe evitar el cierre primario en la línea media 21 , instalando la línea de sutura en posición lateral a aquella, lo que reduce de modo importante la recurrencia de la enfermedad. El colgajo de Limberg 6,13-15 y el de Karydakis 1,5,[10][11][12]20 cumplen completamente con ese concepto, Pero, no son las únicas, porque, se han descrito otras técnicas menos difundidas, que también muestran buenos resultados: colgajo de transposición en W, avance de colgajo V en Y o colgajo en triple L [23][24][25] . no se ha incluido el colgajo en triple L de Defourmentel en este análisis, porque, si bien a primera vista parece igual al diseño de Limberg, el primero tiene una base mucho más amplia y el vértice vecino al defecto es un ángulo de 150 grados.…”

Out of the midline—cleft lift, advancement and rotation procedures

“…The House flap [53] has recently been described for what appears to be simple disease. Z-plasty [54][55][56][57], V-Y flaps [58][59][60], rhomboid flaps [61,62] and complex plastic surgical techniques such as transverse lumbar artery perforator flap [63] are other techniques that have been used. They have also been compared with each other and with other techniques [47,[55][56][57].…”