Background
Complex sacrococcygeal pilonidal disease is an aggressive disease that requires a
wide excision of the whole natal cleft and all involved tissues. This extensive
excision results in a defect that is not pliable for primary closure. Reconstruction of
the defect by an ideal flap is a practical option.
Objective
This study aimed at assessing the feasibility and the efficacy of the gluteal
fasciocutaneous rotational flap in the management of complex sacrococcygeal
pilonidal sinus disease.
Patients and methods
During the period from April 2018 to March 2020, 40 patients with complex
sacrococcygeal pilonidal sinus disease presented to the General Surgery
Department, Benha University Hospital, for management of this complex
disease. All the patients underwent complete excision of the disease and
reconstruction of the defect by a gluteal fasciocutaneous rotational flap.
Results
The study group included 40 patients. The mean age±SD was 27.03±7.26. Five
(12.5%) patients had recurrent disease. The mean operative time was 55.0
±8.16 min. All patients were discharged within 24 h postoperatively. The mean
time to return to normal daily activities was 2.55±0.68 days, whereas the mean time
to return to work was 2.91±0.87 weeks, and the mean follow-up was 14.95±3.2
months (range, 10.0–18.0 months). One (2.5%) patient had a recurrence in the
second year of the follow-up.
Conclusion
Gluteal fasciocutaneous rotational flap is a feasible, simple, and reliable method for
reconstruction of a wide defect after excision of a complex sacrococcygeal pilonidal
sinus disease.
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