Pilonidal Disease of Natal Cleft, Pilonidal Sinus, Surgical Technique
Conditions
Keywords
Karydakis modification, pilonidal sinus, seroma
Brief summary
The aim of this study was to reduce the residual dead-space volume with a modification following the standard Karydakis procedure.
Detailed description
All patients were operated in the jack-knife position under spinal anesthesia (SA). The gluteal parts of the patients were stretched in both directions with bandage and intergluteal cleft was opened. Methylen blue was administered from the sinus openings in the gluteal region. Then, total sinus excision was performed, including the entire sinus tracts by passing the skin, subcutaneous tissues up to the presacral fascia. In patients operated with standard Karydakis procedure, a flap (Karydakis flap) extending along the incision was prepared, with the medial side of the wound to be 1 cm deep and 2-3 cm inward. The prepared flap was shifted to medial and sutured to the presacral fascia with 2/0 vicryl. In patients who were operated with the Asymmetric Primary Closure with Skin Excision Technique, after the Karydakis flap was formed, 5-10 mm skin was excised along the incision from the side of the flap to reduce the volume of the dead-space laterally. In both groups, subcutaneous tissue was approximated with 2/0 vicryl. The skin was sutured with mattress technique using 2/0 Prolene. No drains were used in patients from either group. Patients were followed up for wound leakage, seroma and hematoma formation, skin dehiscence and recurrence.
Interventions
PROCEDUREAsymmetric Primary Closure and Additional Skin Excision Technique
In this new technique, following total sinus excision, the excision defect was closed with the standard Karydakis method, but an advancement tissue flap was performed using additional skin excision, in order to reduce the dead-space volume.
PROCEDUREStandard Karydakis technique.
In this new technique, following total sinus excision, the excision defect was closed with the standard Karydakis method
Sponsors
Siverek Devlet Hastanesi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* All patients between age of 18-65 who had chronic pilonidal disease
Exclusion criteria
* Patients who did not accept the procedure * Patients had undergone previous pilonidal sinus surgery * Patientshad active infection * Patients who were not minimum of 18 years of age
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Early postoperative complications. | 3 years | wound dehiscence, formation of seroma, hematoma, wound infection |
Outcome results
None listed