title: Risk factors for complications and recurrence after the Karydakis flap.
abstract: This study describes risk factors leading to the development of various postoperative complications and recurrence after the Karydakis procedure.
  
  
  
  In this prospective analytic cohort study, 179 patients with sacrococcygeal pilonidal disease underwent Karydakis procedure. Characteristics of the pilonidal disease and excised ellipse were measured as possible risk factors. Postoperative complications and recurrence were recorded as outcomes.
  
  
  
  Multivariate analysis showed that the distance between the last caudal pit and anal verge and length of excised part are independent factors predicting limited superficial skin disruption and infection, respectively. Delayed wound healing was associated with the distance between the last caudal pit and anal verge and history of previous pilonidal surgery. The length of excised part was the only predictor of future recurrence.
  
  
  
  Patients with no history of previous pilonidal surgery, a short length of extracted part, and long distance of caudal pit from anal verge are best candidates for the Karydakis flap procedure.
authors.affiliation: Department of Surgery, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Keshvari
authors.affiliation: Department of Surgery, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: morezak@hotmail.com.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Keramati
authors.affiliation: Department of Surgery, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Sadegh
authors.initials: MS
authors.lastname: Fazeli
authors.affiliation: Department of Surgery, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Kazemeini
authors.affiliation: Department of Surgery, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Nouritaromlou
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010864:Pilonidal Sinus / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D057234:Preoperative Period; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012307:Risk Factors; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult
keywords: Pilonidal sinus; Postoperative complications; Recurrence; Risk factors; Surgical flap