Multicenter prospective randomized trial comparing modified Limberg flap transposition and Karydakis flap reconstruction in patients with sacrococcygeal pilonidal disease.
BACKGROUND
There is still no consensus as to the optimal treatment for sacrococcygeal pilonidal disease (SPD). Many recommend off-midline closure, if any excisional procedure is to be selected.


METHODS
The authors prospectively studied 145 patients with SPD who presented at 3 hospitals. Patients were randomly assigned to undergo either modified Limberg flap (MLF) transposition (n = 72) or Karydakis flap reconstruction (n = 73). Surgical findings, complications, recurrence rates, and degree of patient satisfaction, evaluated via a standardized telephone interview, were compared.


RESULTS
Operation time was longer in the MLF group. There were no significant differences between the two groups in terms of complication rate, length of stay, or recurrence rate. Patients in the Karydakis group reported feeling completely healed more quickly postoperatively. The two groups reported similar rates of satisfaction. Mandatory patient withdrawal from a given study arm because of the orifice straying from the midline occurred more frequently in the Karydakis group.


CONCLUSIONS
The MLF technique and the Karydakis procedure appear to generate comparable outcomes. With laterally situated orifices, however, the applicability of the Karydakis method may be limited.
Can
Mehmet Fatih
MF
Department of Surgery, Ardahan Army Community Hospital, Ardahan, Turkey. mfcan@gata.edu.tr
Sevinc
Mert Mahsuni
MM
Hancerliogullari
Oguz
O
Yilmaz
Mehmet
M
Yagci
Gokhan
G
D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010864:Pilonidal Sinus / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D012445:Sacrococcygeal Region / Q000601:surgery*; D018709:Statistics, Nonparametric; D013524:Surgical Flaps; D016896:Treatment Outcome