Alaa M. Sewefy
Minia University Hospital, Egypt
Title: Karydakis flap with compressing tie-over interrupted sutures without drain versus standard karydakis for treatment of sacrococcygeal pilonidal sinus disease
Biography
Biography: Alaa M. Sewefy
Abstract
Background: Sacroccygeal pilonidal sinus disease (SPSD) is a worldwide health problem, affecting young adult, mainly male, with a tendency for recurrence. Various modalities have been used for treating this condition. Karydakis procedure is one of most commonly used asymmetric flap for treating this condition.
Objective: the study aimed to evaluate Karydakis procedure with tie-over compressing sutures instead of routine use of drain in treatment of SPSD
Design: prospective randomized controlled clinical study conducted between January 2010 and January 2015.
Settings: the study was conducted in Minia university hospital.
Patients: the study included 154 patients. Patients were randomly assigned into 2 groups. Each group included 77 patients.
Interventions: Group 1 operated by standard Karydakis procedure and group 2 by Karydakis procedure with tie-over compressing sutures without drain.
Main outcomes and measures: incidence of seroma formation, wound complications length of hospital stay, off-work time and recurrence rate
Results: all patients discharged on the same day of surgery in group 2 VS. mean hospital stay of 4.9 ± 2.4 day in group 1. No patients developed seroma in group 2 VS. 7.8% in group 1. 1.3% developed wound infection in group 2 VS. 9.1% in group 1. The average time for return to work in group 2 was 10.2 ± 1.4 days VS. 12.6 ± 4 days in group 1. No recurrences were noted in group 2 VS. 2.6% in group 1
• The limitations: The feedback about postoperative pain and patient's satisfaction about the scar were not investigated. The extent of the disease on both group were not investigated. Relatively short duration of follow up to accurately weight recurrence rate.
Conclusion: Karydakis flap with tie-over compressing interrupted sutures without drain is safe, one day surgery with least complications rate.