KARYDAKIS FLAP ON SACROCOCCYGEAL PILONIDAL DISEASE: A BRIEF REVIEW AND DEPARTMENT EXPERIENCE
DOI:
https://doi.org/10.34635/rpc.1018Keywords:
Surgical Flaps, Surgical Wound Dehiscence, Recurrence, Treatment Outcome, pilonidal sinus surgeryAbstract
Introduction: The sacrococcygeal pilonidal disease (SPD) represents a group of abscesses or sinuses with hairy content, occurring in the intergluteal cleft. Karydakis flap (KF) technique is based on the excision of SPD with a mobilized fasciocutaneous flap, with lateral suture lines. With this flap, by decreasing tension in the surgical wound, leads to less pain, faster recovery and, therefore, it reduces recurrence and complication rates. Due to the low learning curve and high reproducibility rate, this technique was routinely introduced in our Department.Methods: This retrospective study comprised patients submitted to chronic SPD excision between January 2010 and December 2017. Out of 1621 patients, 97 underwent chronic SPD excision under KF technique. Patient data were obtained by analyzing Institution records and making phone calls inquiring surgical complications. Results: Our recurrence rate was 3.1% (n=3) and post-operative complication was 19.6% (n=19).
Discussion: recurrence rate matches the consulted literature for the same procedure: 4% for Kitchen et al., 3.16% for Erkent et al., <1% for Karydakis and 6% for Ferreira et al.. Complication rate was relatively high (19.6%) but similar to some published literature (21% for Petersen et al. and 19% for Kartal et al.; 14% for Ferreira et al.; 10.1% for Erkent et al. and 8.5% for Karydakis).
Conclusion: In agreement with the published literature, this technique is therefore validated for use in our Institution.
Downloads
Download data is not yet available.
References
1. Mayo OH. Observations on injuries and diseases of the rectum. London: Burgess and Hill, 1833:45-6
2. Kitchen PR. Pilonidal sinus: experience with the Karydakis flap. The British journal of surgery. 1996; 83(10):1452–5.
3. Karydakis GE. New approach to the problem of pilonidal disease. Lancet 1973;2:1414-5.
4. Gavriilidis P, Bota E. Limberg flap versus Karydakis flap for treating pilonidal sinus disease: A systematic review and meta-analysis. Canadian Journal of Surgery. 2019;62(2):131–8.
5. Kartal A, Aydın HO, Oduncu M, Ferhatoğlu MF, Kıvılcım T, Filiz Aİ. Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery. Prague Medical Report. 2018; 119(4):148–55.
6. Erkent M, Şahiner İT, Bala M, Kendirci M, Yıldırım MB, Topçu R, et al. Comparison of Primary Midline Closure, Limberg Flap, and Karydakis Flap Techniques in Pilonidal Sinus Surgery. Medical science monitor : international medical journal of experimental and clinical research. 2018; 24:8959–63.
7. Ferreira B, Contente H, Gameiro H, Resende C, Neves C. Tratamento da doença pilonidal: experiência com a plastia de Karydakis. Revista Portuguesa de Cirurgia. 2009; (10):27–33.
8. Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. The Australian and New Zealand journal of surgery. 1992; 62(5):385–9.
9. Petersen S, Aumann G, Kramer A, Doll D, Sailer M, Hellmich G. Short-term results of Karydakis flap for pilonidal sinus disease. Techniques in Coloproctology. 2007; 11(3):235–40.
10. Johnson EK, Vogel JD, Cowan ML, Feingold DL, Steele SR, Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons’ Clinical Practice Guidelines for the Management of Pilonidal Disease. Diseases of the colon and rectum. 2019; 62(2):146–57.
2. Kitchen PR. Pilonidal sinus: experience with the Karydakis flap. The British journal of surgery. 1996; 83(10):1452–5.
3. Karydakis GE. New approach to the problem of pilonidal disease. Lancet 1973;2:1414-5.
4. Gavriilidis P, Bota E. Limberg flap versus Karydakis flap for treating pilonidal sinus disease: A systematic review and meta-analysis. Canadian Journal of Surgery. 2019;62(2):131–8.
5. Kartal A, Aydın HO, Oduncu M, Ferhatoğlu MF, Kıvılcım T, Filiz Aİ. Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery. Prague Medical Report. 2018; 119(4):148–55.
6. Erkent M, Şahiner İT, Bala M, Kendirci M, Yıldırım MB, Topçu R, et al. Comparison of Primary Midline Closure, Limberg Flap, and Karydakis Flap Techniques in Pilonidal Sinus Surgery. Medical science monitor : international medical journal of experimental and clinical research. 2018; 24:8959–63.
7. Ferreira B, Contente H, Gameiro H, Resende C, Neves C. Tratamento da doença pilonidal: experiência com a plastia de Karydakis. Revista Portuguesa de Cirurgia. 2009; (10):27–33.
8. Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. The Australian and New Zealand journal of surgery. 1992; 62(5):385–9.
9. Petersen S, Aumann G, Kramer A, Doll D, Sailer M, Hellmich G. Short-term results of Karydakis flap for pilonidal sinus disease. Techniques in Coloproctology. 2007; 11(3):235–40.
10. Johnson EK, Vogel JD, Cowan ML, Feingold DL, Steele SR, Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons’ Clinical Practice Guidelines for the Management of Pilonidal Disease. Diseases of the colon and rectum. 2019; 62(2):146–57.
Downloads
Published
2024-01-11
Issue
Section
Original Papers
License
Para permitir ao editor a disseminação do trabalho do(s) autor(es) na sua máxima extensão, o(s) autor(es) deverá(ão) assinar uma Declaração de Cedência dos Direitos de Propriedade (Copyright). O acordo de transferência, (Transfer Agreement), transfere a propriedade do artigo do(s) autor(es) para a Sociedade Portuguesa de Cirurgia.
Se o artigo contiver extractos (incluindo ilustrações) de, ou for baseado no todo ou em parte em outros trabalhos com copyright (incluindo, para evitar dúvidas, material de fontes online ou de intranet), o(s) autor(es) tem(êm) de obter, dos proprietários dos respectivos copyrights, autorização escrita para reprodução desses extractos do(s) artigo(s) em todos os territórios e edições e em todos os meios de expressão e línguas. Todas os formulários de autorização devem ser fornecidos aos editores quando da entrega do artigo.
