Asymmetric sinus excision and primary closure with additional skin excision technique. Effect of reduction of dead-space with Karydakis modification.

ABSTRACT

OBJECTIVE: Pilonidal sinus is one of the common diseases, although there is still no gold standard of treatment available. The aim of this study was to reduce the residual dead-space volume with a modification following the standard Karydakis procedure. METHODS: A total of 100 patients were included in a randomised controlled trial, who were divided into two groups. Each group included 50 patients, and the patients in Group-1 were treated with the new technique, whereas in Group- 2, the standard Karydakis technique was performed. In the new technique, following total sinus excision, an advancement tissue flap was performed using additional skin excision, in order to reduce the dead-space volume. RESULTS: There was no significant difference in terms of sex, age, and sinus volume. Operation time was longer in first group (p=0,002). Seroma formation rate was higher in the secound group (p=0.036). There was no significant difference in terms of soft tissue infection (p=0.339) and wound dehiscence (p=0.218). The mean follow-up period was 30 months and no recurrence was observed in both groups. CONCLUSIONS: The results of the study suggest that this technique may be considered as an alternative surgical method in pilonidal sinus surgery. KEY WORDS Dead, Karydakis flap-space volume, Sacrococcygeal pilonidal sinus, Seroma, Skin excision.