World Journal of Surgery

, Volume 37, Issue 5, pp 1115–1120 | Cite as

Karydakis Flap for Recurrent Pilonidal Disease

  • Igors IesalnieksEmail author
  • Sina Deimel
  • Hans J. Schlitt



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.


Only patients with previous excision surgery apart from simple abscess incision were included. Disease recurrence was defined as the need for repeat surgery.


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).


Karydakis flap procedure is superior to midline excision surgery in patients presenting with recurrent pilonidal disease.


Pilonidal Disease Flap Procedure Natal Cleft Limberg Flap Sinus Track 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest



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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Igors Iesalnieks
    • 1
    • 2
    Email author
  • Sina Deimel
    • 1
  • Hans J. Schlitt
    • 2
  1. 1.Department of SurgeryMarienhospital GelsenkirchenGelsenkirchenGermany
  2. 2.Department of SurgeryUniversity of RegensburgRegensburgGermany

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