Neoplasms

All Conditions

Symptoms and General Pathology

Respiratory Tract (Lung and Bronchial) Diseases

Ear, Nose, and Throat Diseases

Pilonidal Sinus

Cysts

Paranasal Sinus Diseases

Nose Diseases

Respiratory Tract Diseases

Otorhinolaryngologic Diseases

Vertical eccentric elliptical incision down to the post-sacral fascia, complete removal of unhealthy tissue, and normal tissue around the cyst and sinus tracts. Mobilization of the medial wound edge and advancement of the skin. Flap along the midline to the post-sacral fascia and suturing its margin to the lateral wound margin.

The flap is incised along the base of the wedge-shaped defect, and a small Burow's triangle is excised on the opposite side. The skin is mobilized and shifted in the direction of the arrow to close the defect. Excising the small Burow's triangle eliminates a dog ear at the base of the flap.

Pilonidal sinus surgery will be performed with the Karydakis Flap procedure.

Karydakis Flap Procedure

Pilonidal sinus surgery will be performed with the Burow's Triangle Advancement Flap procedure.

Burow's Triangle Advancement Flap Procedure

Muhammer Ergenç, MD

In this study, we aim to compare the Karydakis flap and Burow's Triangle Advancement Flap techniques applied in the surgical treatment of pilonidal sinus in terms of complications, time to return to normal activity, and recurrence.

Pilonidal sinus disease (PSD) is a chronic and inflammatory disease that is often generated in the sacrococcygeal region. It is commonly observed in puberty and young adult period and usually affects men. The incidence of pilonidal sinus disease is 26:100,000 and rising globally.

PSD risk factors contain young age, obesity, male gender, Mediterranean ethnicity, deep natal cleft, hairiness, and poor hygiene. It has been shown that PSD incidence increases in parallel with body weight. The precise etiology of pilonidal sinus disease is unclear. Many conservative and surgical methods have been described in treating pilonidal sinus disease. After the sinus area is excised, excision with laying open (secondary healing), excision with primary closure, marsupialization, and various flap techniques can be applied in surgical treatment. The primary principle in treatment is to ensure that the patient returns to normal life as soon as possible and eliminate recurrences. Although the best surgical technique in treating pilonidal sinus is controversial, the ideal operation should be cost-effective, simple to perform, short hospital stay, and have a low recurrence and complication rates. There is no definite consensus on an ideal technique yet.

In this study, we aim to compare the Karydakis flap and Burow's Triangle Advancement Flap techniques applied in the surgical treatment of pilonidal sinus in our clinic in terms of complications (wound dehiscence, seroma, hematoma, surgical site infection), time to return to normal activity, and recurrence.

Karydakis Flap Versus Burow's Triangle Advancement Flap in the Surgery of Sacrococcygeal Pilonidal Sinus Disease

Karydakis Flap Procedure Versus Burow's Triangle Advancement Flap Procedure in the Surgical Treatment of Sacrococcygeal Pilonidal Sinus Disease

Postoperative pain after surgery ( measured by the visual analog score with 1 being minimum score and 10 being maximum score)

Number of weeks of complete duration epithelialization of the wound

Number of complications; related to the surgery, Type (wound dehiscence, seroma, hematoma, surgical site infection)

The number of weeks it passes the patient to return to normal activity.

Number of patients with recurrence pilonidal disease

Istanbul Sultanbeyli State Hospital

Recurrence

Anti-Infective Agents

Pharmaceutical Solutions

All Drugs and Chemicals

Phenol

Anti-Infective Agents, Local

Disinfectants

Sclerosing Solutions

Crystallized phenol application for pilonidal disease treatment. After sacrococcygeal region of the patient is cleaned from hairs, hairs inside the sinus are removed than crystallized phenol is applied in to the cleaned sinus. Following 2 minutes of phenol exposure, crystallized phenol is removed from the sinus. Crystallized phenol application will be repeated weekly for 4 weeks.

Crystallized phenol

Limberg Flap surgery for pilonidal disease treatment

Limberg Flap

Limberg flap surgery rhomboid incision is made asymmetrically 2-3 cm lateral to the midline on the side opposite to the donor area.

Modified Limberg Flap

Karydakis Flap surgery for pilonidal disease treatment

Karydakis Flap

Osman Doğru, M.D.

Although surgical techniques such as limberg flap. modified limberg flap and karydakis are currently most popular treatment methods for pilonidal disease, crystallized phenol application is also successfully used for pilonidal sinus treatment by different centers. We believe crystallized phenol application could become a good alternative to popular surgical interventions using transposition flaps.

Pilonidal sinus disease (PSD) is usually located at sacrococcygeal region of the body and mostly effect young males causing loss of labor and school time. Its incidence is reported 26 per 100000 in a Norwegian study. Although there are many treatment modalities either surgical or conservative, ideal treatment is still a matter of debate. Surgical techniques such as limberg flap, modified limberg flap and karydakis are most popular treatment methods for pilonidal disease crystallized phenol application is also successfully used for pilonidal sinus treatment by different centers. We would like to compare flap techniques and crystallized phenol application for complications, recurrence, patient comfort, duration of recovery and return to work. We believe crystallized phenol application could become a good alternative to popular surgical interventions using transposition flaps.

Crystallized Phenol Versus Transposition Flaps for Treatment of Pilonidal Disease: A Prospective Study

Crystallized Phenol Application Versus Transposition Flaps for Treatment of Sacrococcygeal Pilonidal Disease: A Prospective Randomized Study

Patients will be queried for when they felt comfortable to return to work and/or their routine physical activity.

Patients will be followed up for recurrence for three years. Total recurrence will be evaluated at the end of 3rd year.

Patients will be queried for patient comfort at the end of first year

Post procedure wound recovery duration will be recorded

Patients will be followed up for procedure related complications.

S.B. Konya Education and Research Hospital

Neoplasm Metastasis

Karydakis flap is a type of primary repair of the wound, after complete excision of sacral pilonidal cyst with 2 characteristics 1)lateralization of final scar 2)flattening of natal cleft

karydakis flap

laying open the site of excision of sinus or cyst without any flap

laying open

Amir Keshvari, Assoc. Prof.

Recurrence, Complications, Work-off date, Healing time and Patients Willingness in Karydakis Technique for Treatment of Sacrococcygeal Pilonidal Sinus versus Healing by Secondary Intention (EHSI) Technique in Imam Khomeini Hospital from 2008 to 2011

Karydakis Procedure Versus Excision With Healing by Secondary Intention (EHSI) in Sacrococcygeal Pilonidal Sinus

Recurrence, Complications, Work-off Date, Healing Time and Patients Willingness in Karydakis Technique for Treatment of Sacrococcygeal Pilonidal Sinus Versus Excision With Healing by Secondary Intention (EHSI)Technique

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Karydakis Flap Versus Burow's Triangle Advancement Flap in the Surgery of Sacrococcygeal Pilonidal Sinus Disease	NCT05289297	Pilonidal Sinus Sacrococcygeal ...	Karydakis Flap ... Burow's Triangl...	18 Years - 65 Years	Istanbul Sultanbeyli State Hospital
Crystallized Phenol Versus Transposition Flaps for Treatment of Pilonidal Disease: A Prospective Study	NCT01792557	Pilonidal Sinus	Crystallized ph... Limberg Flap Modified Limber... Karydakis Flap	18 Years - 65 Years	S.B. Konya Education and Research Hospital
Karydakis Procedure Versus Excision With Healing by Secondary Intention (EHSI) in Sacrococcygeal Pilonidal Sinus	NCT00716937	Pilonidal Sinus Pilonidal Cyst	karydakis flap laying open	10 Years - 90 Years	Tehran University of Medical Sciences

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