Pilonidal Sinus Clinical Trial
Official title:
A Novel Technique in the Treatment of Sacrococcygeal Pilonidal Sinus Disease: Effect of Reduction of Dead-space With Asymmetric Primary Closure and Additional Skin Excision Technique.
The aim of this study was to reduce the residual dead-space volume with a modification following the standard Karydakis procedure.
All patients were operated in the jack-knife position under spinal anesthesia (SA). The
gluteal parts of the patients were stretched in both directions with bandage and intergluteal
cleft was opened. Methylen blue was administered from the sinus openings in the gluteal
region. Then, total sinus excision was performed, including the entire sinus tracts by
passing the skin, subcutaneous tissues up to the presacral fascia.
In patients operated with standard Karydakis procedure, a flap (Karydakis flap) extending
along the incision was prepared, with the medial side of the wound to be 1 cm deep and 2-3 cm
inward. The prepared flap was shifted to medial and sutured to the presacral fascia with 2/0
vicryl.
In patients who were operated with the Asymmetric Primary Closure with Skin Excision
Technique, after the Karydakis flap was formed, 5-10 mm skin was excised along the incision
from the side of the flap to reduce the volume of the dead-space laterally.
In both groups, subcutaneous tissue was approximated with 2/0 vicryl. The skin was sutured
with mattress technique using 2/0 Prolene. No drains were used in patients from either group.
Patients were followed up for wound leakage, seroma and hematoma formation, skin dehiscence
and recurrence.
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