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Complete natal cleft removal with kite incision in the treatment of extensive sacrococcygeal pilonidal sinus
Author(s) -
Ozdemir Hakan,
Unal Ozdemir Zehra,
Sunamak Oguzhan
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15550
Subject(s) - medicine , surgery , sinus (botany) , complication , seroma , pilonidal disease , wound healing , botany , biology , genus
Background Pilonidal sinus (PS) is a benign disease for which different treatment modalities are used, varying from non‐surgical treatments to surgical treatments with flap use for big defects. High recurrence is the main problem in complicated cases. We presented complete natal cleft excision with kite incision and fasciocutaneous flap (CNCEF with kite incision) in extensive sacrococcygeal PS. Methods Seventy‐six patients who underwent CNCEF with kite incision because of extensive PS extending through intergluteal sulcus to the anus, with multiple sinus tracts and recurrent PS were retrospectively analysed. A special incision involving natal cleft and all sinus tracts completely and fasciocutaneous flap, lateralizing median line, was used in all cases. Post‐operative complications and recurrence was recorded. Results Sixteen (21.1%) patients were operated because of recurrence. The mean age and body mass index were 33.04 ± 6.78 and 29.86 ± 5.46, respectively. The mean hospital stay period and mean operation time was 2.95 ± 0.76 days and 64.33 ± 8.64 min, respectively. The mean drain removal time was 2.78 ± 0.7 days and mean follow‐up was 13.46 ± 4.31 months. There were flap oedema and seroma in one (1.3%) and four (5.3%) of the patients, respectively. Surgical site infection necessitating antibiotic treatment developed in three (3.9%) patients. The overall post‐operative complication rate was 10.5% and there was recurrence in one patient on follow‐up period (1.3%). Conclusion CNCEF with kite incision method, which shifts midline, is a safe and reliable method with acceptable post‐operative complication and recurrence rates in extensive sacrococcygeal PS patients.