Kite excision in complicated pilonidal sinuses: A retrospective cohort study of a tissue-sparing technique

Abstract

Background/Aim: Pilonidal sinus (PS) is a benign chronic condition that primarily affects young people and can have a significant impact on their social life and work. Treatment options range from minimally invasive methods to surgical interventions involving wide excision. This study evaluates the outcomes of Kite excision, which aims to preserve healthy tissues, in cases of complicated PS extending along the natal cleft line. Methods: This retrospective cohort study included cases of complicated PS extending along the intergluteal sulcus. Patients with minimally extended PS, sinus openings extending laterally, or patients in whom the defect area was closed using other methods (e.g., rotation flap or Limberg flap) were excluded. Patient data were obtained from medical records and the hospital information system: patient age, gender, body mass index (BMI), length of hospital stay, duration of drainage, follow-up period, presence of flap necrosis or flap edema, wound dehiscence, and presence of seroma, hematoma, or surgical-site infections. Results: A total of 41 patients were included in the study; five (12%) were female. Twenty-three patients (56%) had recurrent PS; 18 patients (44%) underwent surgery for the first time. The mean age of the cohort was 28.5 years (standard deviation: 5.1 years). The mean BMI of the group was 30.2 kg/m2 (standard deviation: 2.9 kg/m2), and the mean hospital stay was 1.3 days (standard deviation: 0.6 days). Wound dehiscence was observed in two patients (4.9%), and hematoma beneath the flap was observed in one patient (2.4%). Seroma was detected in one patient (2.4%). A surgical-site infection was identified in two patients (4.9%). The overall postoperative complication rate was 14.6%, and recurrence was observed in one patient (2.4%). Conclusion: Kite excision performed along the natal cleft line in cases of complicated PS is a safe, effective, and minimally invasive procedure that preserves healthy tissues. It is a recommended surgical treatment option in cases of complicated PS with vertical extension, and it will reduce the incidence of recurrence and increase patient comfort.