title: Surgical treatment of complicated pilonidal sinus with a fasciocutaneous V-Y advancement flap.
abstract: 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.
authors.affiliation: Department of Surgery, Vakif Gureba Training Hospital, Istanbul, Turkey. eryilmazramazan@hotmail.com
authors.forename: Ramazan
authors.initials: R
authors.lastname: Eryilmaz
authors.forename: Ismail
authors.initials: I
authors.lastname: Okan
authors.forename: Aytekin
authors.initials: A
authors.lastname: Coskun
authors.forename: Gurhan
authors.initials: G
authors.lastname: Bas
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sahin
mesh_terms: 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