title: Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap.
abstract: BACKGROUND
  The ideal treatment for pilonidal sinus disease has yet to be defined. There are many approaches described in the literature.
  
  
  METHODS
  Thirty-five consecutive patients who underwent wide excision of pilonidal sinus disease had the wound repaired using a parasacral perforator  flap. Outcomes were assessed by case notes analysis and follow-up telephone and postal questionnaires.
  
  
  RESULTS
  There were ten minor complications including six minor wound edge dehiscences. There were two ischaemic complications, with one flap loss. There were 3 recurrences of pilonidal  disease at a mean follow-up of 33 months, giving a 5-year recurrence free rate of 86%. Of the patients questioned, all would recommend the procedure to someone else despite 69% being dissatisfied with the cosmetic outcome.
  
  
  CONCLUSIONS
  This series indicates that the parasacral perforator  flap technique is able to repair pilonidal sinus excision wounds successfully with minimal morbidity and a low recurrence rate at a mean of follow-up of 33 months. The study suggests that it may be a technique best reserved for recurrent cases of pilonidal sinus disease. Patients feel the  procedure is successful despite reservations regarding the cosmetic outcome.
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, UK. matt@mattvenus.co.uk
authors.forename: M R
authors.initials: MR
authors.lastname: Venus
authors.forename: O G
authors.initials: OG
authors.lastname: Titley
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010864:Pilonidal Sinus / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult