Background: Pilonidal sinus disease is an acquired condition, usually seen in young adults, that carries high postoperative morbidity and patient discomfort. The most important predisposing factors for the development of pilonidal sinus are the existence of a deep natal cleft and the presence of hair within the cleft. A deep natal cleft is a favorable environment for sweating, maceration, bacterial contamination, and penetration of hairs. Thus, for treatment and prevention, these causative factors must be eliminated.
Aim of this study is to compare between two different modalities of closed technique either karydakis technique versus rhomboidal flap in management of pilonidal sinus in terms of incidence of (a) post-operative pain, (b) total hospital stay, (c) total recovery time, (d) complications in the form of wound dehiscence and recurrence rate
Methodology: The patients were randomly divided using block randomization method 1: 1 into two groups according to surgical technique used for the treatment of the pilonidal sinus without selection off criteria used in selection of the technique.
Each group consisted of 20 patients: Group 1 (Karydakis technique): Twenty patients were treated be excision and closure by karydakis technique. Group 2 (Rhomboid flap technique): Twenty patients were treated by excision and closure by transposition rhomboid flap technique (Limberg Flap).
Results: The results of our study support the Karydakis technique and Limberg flap as a preferred treatment of the disease as they have special characteristics like flatting of natal cleft and shifting of the scar from the midline especially the lower angle which is the commonest site of recurrence with some superiority of karydakis flap over rhomboidal flap in early removal of stiches ,early return to work and early return to work with no statistically significant difference in rate of recurrence. The technique can be mastered easily and provides an effective procedure for primary as well as recurrent disease with few complications.
Conclusion: Karydakis technique and Limberg flap as a preferred treatment of the disease as they have special characteristics like flatting of natal cleft and shifting of the scar from the midline especially the lower angle.
Declaration of conflicting interests
The authors declare no potential conflicts of interest with respect to the research, authorship and publication of this article
Financial disclosure
The authors receive no financial support for the research project or in any techniques or equipment used in this study or in the publication of this article.
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