Comparison of different surgical techniques of sacrococcygeal pilonidal sinus disease

Abstract

Pilonidal sinus, especially in young males, is one of the most common diseases of the sacrococcygeal region. Although many surgical techniques have been described for pilonidal sinus disease (PSD), high recurrence rates and patient satisfaction are still controversial with regard to the ideal treatment modality. In this study, we aimed to compare the complications in Primary excision, Limberg flap, elliptical rotation flap and karydakis techniques used in patients with pilonidal sinus disease. The patients who were diagnosed with Pilonidal sinus and underwent surgery between January 2012 and January 2017 were retrospectively analysed from our hospital database. Patients in whom the Primary repair, Limberg flap, elliptical rotation flap and karydakis flap repair performed were divided into four groups. The groups were compared in terms of their demographic characteristics, length of hospitalization, seroma formation, surgical site infections, wound dehiscence, flap necrosis, sensory loss and recurrence. There were 107 patients in the primary group, 70 in the Limberg flap group, 72 in the elliptical rotation flap group and 45 in the karydakis flap group. There was a statistically significant difference between the groups in terms of the length of hospitalization (p < 0.001). The maximum length of hospitalization period was observed in the Limberg group and was 2.06 ± 0.95 days. The minimum duration of hospitalization was 1.00 ± 0.00 days in the karydakis group. Wound site infection was observed mostly in the primary group with 15% frequency, whereas this higher ratio was significant when compared with Elliptical Rotation flap and Karydakis flap groups (p = 0.010, 0.024 respectively). There was no statistically significant difference between the groups in terms of wound dehiscence, flap necrosis, sensory loss and recurrence. There is no consensus on the ideal surgical technique selection for PSD. Our study revealed that wound infection is common in patients undergoing Primary repair and that there is a difference in terms of length of hospitalization for different techniques. We expect the factors we investigate to be a guide for the surgeons.