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World Journal of Surgery

, Volume 42, Issue 11, pp 3568–3574 | Cite as

A New Oval Advancement Flap Design for Reconstruction of Pilonidal Sinus Defect

  • Enver Arpaci
  • Serdar Altun
  • Erkan Orhan
  • Atilla Eyuboglu
  • Nilgun Markal Ertas
Original Scientific Report

Abstract

Backgrounds

Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Although many surgical methods have been described for treating pilonidal sinus disease, controversy still exists as to the best surgical technique. The aim of this study is to present a new modified advancement flap technique named “omega flap” for the treatment of pilonidal sinus disease.

Materials and methods

This study included 18 patients with pilonidal sinus who were treated between March 2012 and August 2014. All cases underwent oval excision and omega advancement flap reconstruction. Defect size, postoperative complications, postoperative pain, painless sitting time, patient satisfaction and recurrence were evaluated retrospectively.

Results

All patients were discharged on the first postoperative day. There was no flap necrosis. No recurrence and no major complication were observed during follow-up period. The outcomes were also satisfactory regarding functionally and aesthetically, and the patients were satisfied with the results.

Conclusions

Presented method has a different geometry than classical advancement flap methods. Our technique provides two-layered repair with minimal tension and off-midline closure for the reconstruction of pilonidal sinus defect. It is easily performed, reliable, associated with no recurrens and good aesthetic results.

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    Karydakis GE (1992) Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg 62(5):385–389CrossRefGoogle Scholar
  2. 2.
    Eryilmaz R, Sahin M, Alimoglu O et al (2003) Surgical treatment of sacrococcygeal pilonidal sinus with the Limberg transposition flap. Surgery 134:745–749CrossRefGoogle Scholar
  3. 3.
    Nessar G, Kayaalp C, Seven C (2004) Elliptical rotation flap for pilonidal sinus. Am J Surg 187:3CrossRefGoogle Scholar
  4. 4.
    Sungur N, Kocer U, Uysal A et al (2006) V–Y rotation advancement fasciocutaneous flap for excisional defects of pilonidal sinus. Plast Reconstr Surg 117:2448–2454CrossRefGoogle Scholar
  5. 5.
    Yilmaz S, Kirimlioglu V, Katz D (2000) Role of simple V–Y advancement flap in the treatment of complicated pilonidal sinus. Eur J Surg 166:269–272CrossRefGoogle Scholar
  6. 6.
    Sahasrabudhe P, Panse N, Waghmare C et al (2012) V–Y advancement flap technique in resurfacing postexcisional defect in cases with pilonidal sinus disease-study of 25 cases. Indian J Surg 74(5):364–370CrossRefGoogle Scholar
  7. 7.
    Eryilmaz R, Okan I, Coskun A et al (2009) Surgical treatment of complicated pilonidal sinus with a fasciocutaneous V–Y advancement flap. Dis Colon Rectum 52(12):2036–2040CrossRefGoogle Scholar
  8. 8.
    Öz B, Akcan A, Emek E et al (2017) A comparison of surgical outcome of fasciocutaneous V–Y advancement flap and Limberg transposition flap for recurrent sacrococcygeal pilonidal sinus disease. Asian J Surg 40(3):197–202CrossRefGoogle Scholar
  9. 9.
    Unalp HR, Derici H, Kamer E et al (2007) Lower recurrence rate for Limberg vs. V–Y flap for pilonidal sinus. Dis Colon Rectum 50:1436–1444CrossRefGoogle Scholar
  10. 10.
    Altintoprak F, Dikicier E, Arslan Y et al (2013) Comparision of the Limberg flap with the V–Y flap technique in the treatment of pilonidal disease. J Korean Surg Soc 85:63–67CrossRefGoogle Scholar
  11. 11.
    Sabuncuoglu MZ, Sabuncuoglu A, Dandin O et al (2015) Eye-drop shaped, modified Limberg transposition flap in the treatment of pilonidal sinus disease. Asian J Surg 38(3):161–167CrossRefGoogle Scholar
  12. 12.
    Polat C, Gungor B, Karagul S et al (2011) Is oval flap reconstruction a good modification for treating pilonidal sinuses? Am J Surg 201(2):192–196CrossRefGoogle Scholar
  13. 13.
    Arumugam PJ, Chandrasekaran TV, Morgan AR et al (2003) The rhomboid flap for pilonidal disease. Colorectal Dis 5:218–221CrossRefGoogle Scholar
  14. 14.
    Kapan M, Kapan S, Pekmezci S et al (2002) Sacrococcygeal pilonidal sinus disease with Limberg flap repair. Tech Coloproctol 6:27–32CrossRefGoogle Scholar
  15. 15.
    Topgul K, Ozdemir E, Kilic K et al (2003) Long-term results of Limberg flap procedure for treatment of pilonidal sinus: a report of 200 cases. Dis Colon Rectum 46:1545–1548CrossRefGoogle Scholar
  16. 16.
    Ersoy OF, Karaca S, Kayaoglu HA et al (2007) Comparison of different surgical options in the treatment of pilonidal disease: retrospective analysis of 175 patients. Kaohsiung J Med Sci 23:67–70CrossRefGoogle Scholar
  17. 17.
    Mentes BB, Leventoglu S, Cihan A et al (2004) Modified Limberg transposition flap for sacrococcygeal pilonidal sinus. Surg Today 34(5):419–423CrossRefGoogle Scholar
  18. 18.
    Milito G, Cortese F, Casciani CU (1998) Rhomboid flap procedure for pilonidal sinus: result from 67 cases. Int J Colorectal Dis 13:113CrossRefGoogle Scholar
  19. 19.
    Unalp HR, Derici H, Kamer E et al (2007) Lower recurrence rate for Limberg vs. V–Y flap for pilonidal sinus. Dis Colon Rectum 50:1436–1444CrossRefGoogle Scholar
  20. 20.
    Altintoprak F, Dikicier E, Arslan Y et al (2013) Comparision of the Limberg flap with the V–Y flap technique in the treatment of pilonidal disease. J Korean Surg Soc 85:63–67CrossRefGoogle Scholar
  21. 21.
    Limber AA (1966) Design of the local flaps. In: Gibson T (ed) Modern trends in plastic surgery. Sevenoks, ButterworthGoogle Scholar
  22. 22.
    Sevinç B, Karahan Ö, Okuş A et al (2016) Randomized prospective comparison of midline and off-midline closure techniques in spilonidal sinus surgery. Surgery 159(3):749–754CrossRefGoogle Scholar
  23. 23.
    Saydam M, Ozturk B, Sinan H et al (2015) Comparison of modified Limberg flap transposition and lateral advancement flap transposition with Burow’s triangle in the treatment of pilonidal sinus disease. Am J Surg 210(4):772–777CrossRefGoogle Scholar
  24. 24.
    Karaca T, Yoldaş O, Bilgin BÇ et al (2012) Comparison of short-term results of modified Karydakis flap and modified Limberg flap for pilonidal sinus surgery. Int J Surg 10(10):601–616CrossRefGoogle Scholar
  25. 25.
    Onishi K, Maruyama Y (2001) Sacral adipofascial turn-over flap for the excisional defect of pilonidal sinus. Plast Reconstr Surg 108(7):2006–2010CrossRefGoogle Scholar
  26. 26.
    Singh R, Pavithran NM (2005) Adipo-fascio-cutaneous flaps in the treatment of pilonidal sinus: experience with 50 cases. Asian J Surg 28:198–201CrossRefGoogle Scholar
  27. 27.
    Ersoy E, Devay AO, Aktimur R, Doganay B, Ozdoğan M, Gündoğdu RH (2009) Comparison of the short-term results after Limberg and Karydakis procedures for pilonidal disease: randomized prospective analysis of 100 patients. Colorectal Dis 11(7):705–710CrossRefGoogle Scholar
  28. 28.
    Bali İ, Aziret M, Sözen S, Emir S, Erdem H, Çetinkünar S, İrkörücü O (2015) Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease. Clinics (Sao Paulo) 70(5):350–355CrossRefGoogle Scholar
  29. 29.
    Arpaci E, Altun S, Ertas NM, Uysal AC, Inozu E (2017) Omega (Ω) advancement flap: a circular flap design for the aesthetic closure of circular skin defect. Aesthet Plast Surg 41(2):327–334CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Enver Arpaci
    • 1
  • Serdar Altun
    • 2
  • Erkan Orhan
    • 3
  • Atilla Eyuboglu
    • 4
  • Nilgun Markal Ertas
    • 4
  1. 1.Department of Plastic and Reconstructive Surgery, School of MedicineBaskent UniversitySelçuklu-KonyaTurkey
  2. 2.Department of Plastic and Reconstructive Surgery, School of MedicineFirat UniversityElazigTurkey
  3. 3.Department of Plastic and Reconstructive SurgeryNamık Kemal School of MedicineTekirdagTurkey
  4. 4.Department of Plastic and Reconstructive Surgery, School of MedicineBaskent UniversityAnkaraTurkey

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