Prague Med. Rep. 2018, 119, 148-155

Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery

Abdulcabbar Kartal1, Hüseyin Onur Aydın2, Mehmet Oduncu3, Murat Ferhat Ferhatoğlu1, Taner Kıvılcım1, Ali İlker Filiz1

1Department of General Surgery, Okan University Medicine Faculty, Istanbul, Turkey
2Department of General Surgery, Başkent University Medicine Faculty, Ankara, Turkey
3Department of General Surgery, Defne Hospital, Antakya, Turkey

Received August 23, 2018
Accepted January 31, 2019

Our study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Limberg transposition flap (LTF) was performed in 131 patients (group 1), Karydakis flap (KF) was performed in 232 patients (group 2) and primary closure (PC) after excision was performed in 271 patients (group 3). Patient demographics, operative and postoperative outcomes were recorded and analyzed retrospectively. The mean age (p=0.98), sex ratio (p=0.74) and removed sinus volume (p=0.67) were not statistically different between groups. Mean operative time was 54.3 ± 6.4 min for group 1, 46.8 ± 10.5 min for group 2, and 26.9 ± 5.8 min for group 3 respectively (p=0.01). When the length of hospital stay was compared, there was a significant difference in favor of primary closure (p=0.01). Regarding early surgical complication, Karydakis flap technique was superior to other groups (p<0.001). The recurrent rate was higher in the primary closure group (p<0.001). In our study, the primary closure method regarding the duration of surgery and hospitalization; Karydakis method regarding postoperative complications (seroma, hematoma, wound dissociation, infection, recurrence) were superior to the other two methods.


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