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Day-Case Karydakis Flap for Pilonidal Sinus

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

The Karydakis flap for pilonidal sinus is associated with primary wound healing and infrequent recurrence. Previous studies had reported in-patient protocols. This cohort study was designed to assess the feasibility, safety, and practicalities of day-case Karydakis flap surgery. Factors relating to wound healing also were explored.

Methods

Consecutive patients undergoing day-case Karydakis flap surgery, by one consultant surgeon, for pilonidal sinus were studied prospectively. Patients were assessed at weekly intervals after surgery until healing was complete. Wound healing time was compared with 1) patients’ gender, age, body mass index, deprivation index, occupation and smoking status, 2) pilonidal diseases’ dimensions and proximity to anus, 3) wounds’ dimensions and proximity to anus, and 4) drain volume.

Results

Day-case Karydakis flap surgery was feasible, safe, and effective. None of the 51 patients in the study required readmission to hospital, sepsis drainage, or surgery for recurrent sinus. Median wound healing time was three weeks. Smokers healed quicker than nonsmokers. No other factors were identified that were associated with delayed healing. Normal activity was resumed within one month of surgery in 95 percent of patients.

Conclusions

The Karydakis flap can offer the advantage of day-case surgery for pilonidal sinus patients in addition to primary wound healing and low sinus recurrence rates.

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Acknowledgments

The authors thank Dr. D. C. McMillan and Professor C. W. Imrie for reviewing the manuscript and the staff of Glasgow Royal infirmary’s Day Surgery Unit for assistance.

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Authors and Affiliations

  1. Department of Coloproctology, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow, G31 2ER, United Kingdom

    John H. Anderson M.D., Christina O. Yip M.B.Ch.B., J. S. Nagabhushan M.S. & Sheila J. Connelly S.E.N.

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  1. John H. Anderson M.D.
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  2. Christina O. Yip M.B.Ch.B.
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  3. J. S. Nagabhushan M.S.
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  4. Sheila J. Connelly S.E.N.
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Correspondence to John H. Anderson M.D..

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Anderson, J.H., Yip, C.O., Nagabhushan, J.S. et al. Day-Case Karydakis Flap for Pilonidal Sinus. Dis Colon Rectum 51, 134–138 (2008). https://doi.org/10.1007/s10350-007-9150-y

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  • DOI: https://doi.org/10.1007/s10350-007-9150-y

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