title: Outcomes of the house advancement flap for pilonidal sinus.
abstract: BACKGROUND
  Many surgical techniques have been described for the treatment of pilonidal sinus, yet rates of recurrence and prolonged wound healing remain high and consensus on the optimal technique is lacking. This retrospective study evaluates outcomes of the use of the house advancement flap in the treatment of pilonidal sinus including time to wound healing, sinus recurrence, wound infection and flap necrosis.
  
  
  METHODS
  Thirty-three consecutive patients who underwent excision and house advancement flap for pilonidal sinus, of whom seven patients (21%) had recurrent pilonidal sinus disease following previous surgical intervention, were reviewed retrospectively. Follow-up ranged from 4 to 59 months (mean 28 months).
  
  
  RESULTS
  All 33 patients completed a follow-up survey. Age at time of operation ranged from 14 to 44 years with a mean of 25 years. No patients developed wound infection or flap necrosis. Four patients (12%) failed to achieve primary wound healing; mean time to wound healing for the remaining 29 patients was 62 days. Recurrence of pilonidal sinus occurred in eight patients (24%), at a mean time of 22 months post-operatively.
  
  
  CONCLUSIONS
  The house advancement flap achieves primary wound closure in almost 90% of cases with few acute post-operative complications. However delayed wound healing and sinus recurrence remain issues with this technique and it appears to have little advantage over other primary closure techniques.
authors: Colorectal Surgical Unit, St John of God Subiaco Hospital, Perth, Western Australia, Australia.
authors: Alicia
authors: A
authors: Mackowski
authors: Colorectal Surgical Unit, St John of God Subiaco Hospital, Perth, Western Australia, Australia.
authors: Michael
authors: M
authors: Levitt
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009336:Necrosis / Q000150:complications / Q000473:pathology; D010864:Pilonidal Sinus / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000473:pathology / Q000706:statistics & numerical data*; D014945:Wound Healing / Q000502:physiology; D014946:Wound Infection / Q000150:complications; D055815:Young Adult
keywords: pilonidal sinus; recurrence; surgical flap; wound healing; wound infection