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Irish Journal of Medical Science

, Volume 180, Issue 2, pp 479–482 | Cite as

Are postoperative drains necessary with the Karydakis flap for treatment of pilonidal sinus? (Can fibrin glue be replaced to drains?) A prospective randomized trial

  • S. SözenEmail author
  • S. Emir
  • K. Güzel
  • C. Ş. Özdemir
Original Article

Abstract

Purpose

Different surgical techniques for pilonidal disease have been described in the literature. In this study, our aim was to evaluate the influence of routine cavity drainage in the Karydakis flap technique.

Methods

As much as 50 male patients with pilonidal sinus who underwent the Karydakis flap operation were evaluated prospectively.The patients were assigned randomly into two groups (Group 1 with suction drain; Group 2 fibrin glue).

Results

Fluid collection was encountered in 8 out of 50 patients (6.25%): 6 in Group 2 (24%) of which 4 experienced superficial, healed with simple dressing, the other 2 with substantial dehiscence healed with wound dressing; 2 in Group 1 (8%) were treated with wound punctures.There has been no recurrence in any of the patients during the follow-up period.The Karydakis flap operations can be performed with a near zero recurrence rate with the use of drains.

Conclusion

We recommend the use of fibrin sealant with Karydakis flap procedure, but further studies are needed to confirm this conclusion.

Keywords

Fluid Collection Fibrin Glue Fibrin Sealant Hospitalization Time Suction Drain 
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.

Supplementary material

11845_2010_549_MOESM1_ESM.jpg (727 kb)

Suppl. Fig. 1 A line was drawn 2 cm paramedian to the natal cleft. (JPEG 727 kb)

11845_2010_549_MOESM2_ESM.jpg (2 kb)

Suppl. Fig. 2 Lateral secondary opening or scar. (JPEG 2.31 kb)

11845_2010_549_MOESM3_ESM.jpg (2 kb)

Suppl. Fig. 3 Lateral secondary opening or scar. (JPEG 2.07 kb)

11845_2010_549_MOESM4_ESM.jpg (3 kb)

Suppl. Fig. 4 The medial edge of the elipse was incised with a scalpel perpendicular to the skin and down to, but not through, the thoracolumbar fascia overlying the sacrum. (JPEG 3.39 kb)

11845_2010_549_MOESM5_ESM.jpg (4.3 mb)

Suppl. Fig. 5 Using the initial paramedian line as its longitudinal axis, an elipse was drawn that included the entire pilonidal cavity. (JPEG 4.33 kb)

11845_2010_549_MOESM6_ESM.jpg (4 kb)

Suppl. Fig. 6 After deep absorbable sutures are placed 6 ml fibrin sealant (CryoSeal FS System, Thermogenesis, Rancho Cordova, USA) was sprayed on to surgical site and under the flap using a double-barrel syringe and spray tip applicator Afterward, a second layer of absorbable sutures are than placed approaching the two surfaces to close the dead space. (JPEG 3.83 kb)

11845_2010_549_MOESM7_ESM.jpg (2 kb)

Suppl. Fig. 7 A suction drain was placed through a separate incision located 2 cm lateral from the initial incision in Group1 patients. (JPEG 2.21 kb)

11845_2010_549_MOESM8_ESM.jpg (2 kb)

Suppl. Fig. 8 After treatment in Group 2 patients. (2.40 kb)

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Copyright information

© Royal Academy of Medicine in Ireland 2010

Authors and Affiliations

  • S. Sözen
    • 1
    Email author
  • S. Emir
    • 1
  • K. Güzel
    • 2
  • C. Ş. Özdemir
    • 1
  1. 1.Elazığ Training and Reserach Hospital General SurgeryElazigTurkey
  2. 2.Çarşamba State Hospital General SurgerySamsunTurkey

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