KARYDAKIS FLAP ON SACROCOCCYGEAL PILONIDAL DISEASE: A BRIEF REVIEW AND DEPARTMENT EXPERIENCE

Abstract

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.