title: Karydakis flap for recurrent pilonidal disease.
abstract: BACKGROUND
  Patients undergoing surgery for recurrent pilonidal disease are at high risk of developing re-recurrence. The present retrospective analysis was performed to compare long-term results in patients with recurrent disease undergoing midline excision surgery compared to patients undergoing the Karydakis flap procedure.
  
  
  METHODS
  Only patients with previous excision surgery apart from simple abscess incision were included. Disease recurrence was defined as the need for repeat surgery.
  
  
  RESULTS
  A total of 124 patients underwent surgery for recurrent pilonidal disease. Group 1 consisted of 37 patients (25 excision + midline closure, 12 excision + lay-open). Group 2 consisted of 87 patients (Karydakis flap). There were no statistically significant differences between the groups with regard to patient's age, duration of disease, body mass index, or sex. The average number of previous surgeries was significantly higher in group 1 patients (2.1 vs. 1.8, p = 0.019). The overall 1-year recurrence rate was 43 % in group 1 and 3 % in group 2 (p < 0.0001). The wound dehiscence rate after the Karydakis flap procedure was as high as 43 % between years 2005 and 2009, but it fell to 10 % thereafter (p = 0.02).
  
  
  CONCLUSIONS
  Karydakis flap procedure is superior to midline excision surgery in patients presenting with recurrent pilonidal disease.
authors: Department of Surgery, Marienhospital Gelsenkirchen, Virchowstrasse 135, 45886 Gelsenkirchen, Germany. iesalnieks_igors@hotmail.com
authors: Igors
authors: I
authors: Iesalnieks
authors: Sina
authors: S
authors: Deimel
authors: Hans J
authors: HJ
authors: Schlitt
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D010864:Pilonidal Sinus / Q000517:prevention & control / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D055502:Secondary Prevention; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome; D058106:Wound Closure Techniques