Surgical treatment of complicated pilonidal sinus with a fasciocutaneous V-Y advancement flap.
OBJECTIVE
In this study, we investigated the value of fasciocutaneous V-Y advancement flap reconstruction in the treatment of complicated or recurrent sacrococcygeal pilonidal sinus.


METHODS
Patients with complicated pilonidal sinus treated with a V-Y advancement flap from July 2002 through December 2005 were studied. The duration of inpatient stay, early wound complications, time of return to active work, recurrence, and patient satisfaction with the operation were recorded.


RESULTS
Forty-three patients were treated for recurrent or complicated sacrococcygeal pilonidal disease. All flaps remained viable without necrosis. However, 4 patients (9.3%) had wound infections, and 3 patients (7%) had hematoma. The mean hospital stay was 3 (range, 2-5) days, and time to return to active life was 17 (range, 13-25) days. The mean duration of follow-up was 48 (range, 27 to 69) months. Recurrence was detected in only one patient in the early period. Seven patients (16.3%), including 4 bilateral repairs, had numbness over the operative site. Thirty-nine patients (90.7%) were not satisfied with scars; 4 reported that the scar was not important.


CONCLUSIONS
In selected patients, V-Y advancement flaps provide tension-free repair with minimal recurrence rates and reliable skin coverage while flattening the natal cleft that predisposes to recurrence. Because patient dissatisfaction with cosmetic results is high, potential treatment outcomes should be discussed with patients in detail before the operation.
Eryilmaz
Ramazan
R
Department of Surgery, Vakif Gureba Training Hospital, Istanbul, Turkey. eryilmazramazan@hotmail.com
Okan
Ismail
I
Coskun
Aytekin
A
Bas
Gurhan
G
Sahin
Mustafa
M
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010864:Pilonidal Sinus / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012008:Recurrence; D013524:Surgical Flaps; D013530:Surgical Wound Infection; D014945:Wound Healing