Efficiency of New modified inverted Y Cleft lift advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease with low laying tracts near the anus

Abstract

Abstract Propose: The aim of this study was to asses’ efficiency of the new modified inverted Y cleft lift procedure, utilizing an advancement flap technique with off-midline primary wound closure in-patient with lower pits of the sinus near to the anus. Methods: This clinical study conducted from September 2018 to september 2020. Forty patients with sacrococcygeal pilonidal sinus disease with lower pits near the anus new cases or recurrent. All patients offered the new modified inverted Y cleft lift advancement flap patients followed up for 48.5 (range, 21– 57) months Patients evaluated in terms of operation time, postoperative complications, recurrence rate, return-to-work time, and cosmetic satisfaction. Results: The average age was 27.4 (range, 16–52) years, 29 patient (72.5%) were male and 11 (27.5%) were female. The mean operating time was 25 (range, 22– 45) min. and the mean length of hospital stay was 0.8 (range, 0.4 − 2) days. Primary healing occurred in 35 (87.5%) patients. Complete healing for complicated wounds (5 patients) achieved in an average of 21 (14–60) days. Two (5%) patients developed a superficial wound infection, 4 (10%) a seroma and five (12.5%) a partial dehiscence (some complications observed in the same patient). There was no case of deep infection, haematoma formation or complete dehiscence. Conclusion: This series proved that the new modification inverted Y cleft lift flap reconstruction is an effective operative procedure for primary and recurrent pilonidal sinus with pits very near to the anus, associated with low complication and recurrence rates