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Article Type

Original Study

Abstract

Objective A comparative study was carried out between the Karydakis technique and the Limberg flap in the management of sacrococcygeal pilonidal disease. Background Pilonidal sinus is a sinus tract that commonly contains hairs under the skin between the buttocks a short distance above the anus, but can occur elsewhere in the body. The best surgical technique for sacrococcygeal pilonidal disease is still controversial. The aim of this randomized prospective trial was to compare the results of both the Karydakis technique and the Limberg flap. Patients and methods This study included 13 patients with sacrococcygeal pilonidal sinus disease who were assigned randomly. Fifteen patients were subjected to the Karydakis technique and 15 patients received the Limberg flap. Results Our study showed that the time to removal of stitch in the Karydakis group was 12.26 ± 1.66, whereas in the Limberg group, it was 13.66 ± 1.29 (longer in group that received the Limberg flap; P = 0.016). The percentage of complete healing in the Karydakis group was 80%, whereas that in the Limberg group was 66.7% (no significant difference; P ≥ 0.05). Postoperative wound breakdown in the Karydakis group was 13.3%, whereas that in the Limberg group was 26.7% (no significant difference; P ≥ 0.05). Recurrence was 6.7% in the Karydakis group, whereas it was 6.7% in the Limberg group (no significant difference; P ≥ 0.05). The time to return to work was 21.73 ± 6.49 in the Karydakis group, whereas in the Limberg group, it was 28.66 ± 7.50 (longer in the Limberg flap group; P = 0.012), and the duration of surgery in the Karydakis group was 37.73 ± 12.98, whereas that in the Limberg group was 61.60 ± 11.11 (longer in the Limberg flap group; P ≤ 0.001). Conclusion The Karydakis flap procedure had many advantages over the Limberg flap for the treatment of uncomplicated pilonidal sinus because of its lower postoperative complication rate, time to removal of stitches, time to return to work, and duration of surgery. However, there was no difference between the two surgical procedures in terms of prevention of recurrence.

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