Day-case Karydakis flap for pilonidal sinus.
OBJECTIVE
The Karydakis flap for pilonidal sinus is associated with primary wound healing and infrequent recurrence. Previous studies had reported in-patient protocols. This cohort study was designed to assess the feasibility, safety, and practicalities of day-case Karydakis flap surgery. Factors relating to wound healing also were explored.


METHODS
Consecutive patients undergoing day-case Karydakis flap surgery, by one consultant surgeon, for pilonidal sinus were studied prospectively. Patients were assessed at weekly intervals after surgery until healing was complete. Wound healing time was compared with 1) patients' gender, age, body mass index, deprivation index, occupation and smoking status, 2) pilonidal diseases' dimensions and proximity to anus, 3) wounds' dimensions and proximity to anus, and 4) drain volume.


RESULTS
Day-case Karydakis flap surgery was feasible, safe, and effective. None of the 51 patients in the study required readmission to hospital, sepsis drainage, or surgery for recurrent sinus. Median wound healing time was three weeks. Smokers healed quicker than nonsmokers. No other factors were identified that were associated with delayed healing. Normal activity was resumed within one month of surgery in 95 percent of patients.


CONCLUSIONS
The Karydakis flap can offer the advantage of day-case surgery for pilonidal sinus patients in addition to primary wound healing and low sinus recurrence rates.
Anderson
John H
JH
Department of Coloproctology, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow, United Kingdom. j.h.anderson@clinmed.gla.ac.uk
Yip
Christina O
CO
Nagabhushan
J S
JS
Connelly
Sheila J
SJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000556:Ambulatory Surgical Procedures; D015992:Body Mass Index; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010864:Pilonidal Sinus / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing