Day-Case Karydakis Flap for Pilonidal Sinus

Day-Case Karydakis Flap for Pilonidal Sinus

Purpose The Karydakis flap for pilonidal sinus is associated with primary wound healing and infrequent recurrence. Previous studies had reported in-patient protocols. This cohort study was designed to assess the feasibility, safety, and practicalities of day-case Karydakis flap surgery. Factors rela...

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Bibliographic Details
Published in:Diseases of the colon & rectum Vol. 51; no. 1; pp. 134 - 138
Main Authors: Anderson, John H., Yip, Christina O., Nagabhushan, J. S., Connelly, Sheila J.
Format: Journal Article
Language:English
Published: New York Springer-Verlag 2008
The ASCRS
Springer
Lippincott Williams & Wilkins Ovid Technologies
Subjects:
Adolescent
Adult
Age Factors
Ambulatory Surgical Procedures
Biological and medical sciences
Body Mass Index
Colorectal Surgery
Dermatology
Feasibility Studies
Female
Gastroenterology
Humans
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Contribution
Pain Measurement
Pilonidal Sinus - surgery
Postoperative Complications
Prospective Studies
Sex Factors
Smoking - epidemiology
Socioeconomic Factors
Surgery
Surgical Flaps
Surgical Oncology
Treatment Outcome
Tumors of the skin and soft tissue. Premalignant lesions
Wound Healing
Karydakis
Ambulatory surgery
Pilonidal sinus
Skin disease
Treatment
Surgery
Pilonidal cyst
Benign neoplasm
Ambulatory
Flap (surgery)
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Summary:Purpose The Karydakis flap for pilonidal sinus is associated with primary wound healing and infrequent recurrence. Previous studies had reported in-patient protocols. This cohort study was designed to assess the feasibility, safety, and practicalities of day-case Karydakis flap surgery. Factors relating to wound healing also were explored. Methods Consecutive patients undergoing day-case Karydakis flap surgery, by one consultant surgeon, for pilonidal sinus were studied prospectively. Patients were assessed at weekly intervals after surgery until healing was complete. Wound healing time was compared with 1) patients’ gender, age, body mass index, deprivation index, occupation and smoking status, 2) pilonidal diseases’ dimensions and proximity to anus, 3) wounds’ dimensions and proximity to anus, and 4) drain volume. Results Day-case Karydakis flap surgery was feasible, safe, and effective. None of the 51 patients in the study required readmission to hospital, sepsis drainage, or surgery for recurrent sinus. Median wound healing time was three weeks. Smokers healed quicker than nonsmokers. No other factors were identified that were associated with delayed healing. Normal activity was resumed within one month of surgery in 95 percent of patients. Conclusions The Karydakis flap can offer the advantage of day-case surgery for pilonidal sinus patients in addition to primary wound healing and low sinus recurrence rates.
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ISSN:0012-3706
1530-0358
DOI:10.1007/s10350-007-9150-y