Comparison Between Karydakis Flap Repair and Primary Closure for Surgical Treatment of Sacrococcygeal Pilonidal Sinus

Objectives: In this prospective study, we compared primary closure and Karydakis flap repair which has recently proved a popular technique for surgical treatment of pilonidal sinus. Patients and Methods: The study included 48 patients (46 males, 2 females) who were operated on for pilonidal sinus. The patients were randomized to two groups. After sinus excision, 33 patients (group 1) underwent primary closure, and 15 patients (group 2) underwent Karydakis flap surgery. The mean followup was 6.8 months (range 4 to 11 months) in group 1, and 6.2 months (range 3 to 10 months) in group 2. Results: Serous liquid collection and discharge were seen at the site of the lesion in four patients (12.1%) in group 1, and in two patients (13.3%) in group 2. Subcutaneous hematoma was detected in one patient (6.7%) in group 2. During the follow-up period, none of the patients developed wound infection. Recurrences were seen in one patient (3%) in group 1, and in one patient (6.7%) in group 2. Conclusion: Excision and primary closure can be the preferred method for the treatment of pilonidal sinus in selected patients due to its advantages such as ease and simplicity, shorter recovery time, and limited scar formation. Turkish Baslik: Sakrokoksigeal Pilonidal Sinusun Cerrahi Tedavisinde Karydakis Flep Ameliyati ile Primer Kapamanin Karsilastirilmasi Anahtar Kelimeler: Pilonidal sinus/cerrahi; cerrahi flep; dikis teknigi Amac: Bu prospektif calismada, pilonidal sinusun cerrahi tedavisi icin son donemlerde yaygin kullanilan bir teknik olan Karydakis flep ameliyati ile primer kapama teknigi karsilastirildi. Hastalar ve Yontemler: Pilonidal sinus nedeniyle ameliyat edilen 48 hasta (46 erkek, 2 kadin) calismaya alindi. Hastalar iki gruba ayrildi. Sinus eksizyonundan sonra 33 hastaya (grup 1) primer kapama, 15 hastaya (grup 2) ise Karydakis flep ameliyati uygulandi. Ortalama takip suresi grup 1a#39;de 6.8 ay (dagilim 4-11 ay), grup 2a#39;de 6.2 ay (dagilim 3-10 ay) idi. Bulgular: Grup 1a#39;de dort hastada (%12.1), grup 2a#39;de iki hastada (%13.3) yara yerinde seroz sivi birikimi ve akinti saptandi. Grup 2a#39;de bir hastada (%6.7) yara yerinde ciltalti hematom olustu. Takipler sirasinda her iki grupta da hicbir hastada yara yerinde enfeksiyon gorulmezken, grup 1a#39;de bir (%3), grup 2a#39;de yine bir hastada (%6.7) erken donemde nuks goruldu. Sonuc: Uygulanmasi diger yontemlere gore daha kolay ve basit, iyilesme suresi daha kisa ve skar dokusu daha az oldugundan, eksizyon ve primer kapama yontemi uygun olgularda tercih edilen bir ameliyat sekli olabilir.