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Use of a double rhomboid transposition flap in the treatment of extensive complex pilonidal sinus disease
Author(s) -
ElTawil S.,
Carapeti E.
Publication year - 2009
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2008.01596.x
Subject(s) - medicine , rhomboid , surgery , pilonidal disease , dehiscence , complication , sinus (botany) , wound dehiscence , transposition (logic) , wound healing , biology , enzyme , proteases , linguistics , philosophy , biochemistry , chemistry , botany , genus
Objective Rhomboid transposition flaps are safe and successful in treating recurrent, complex pilonidal disease. There are little data on treatment of very large (> 12 cm) pilonidal sinuses. We describe a new technique using two simultaneous rhomboid flaps to achieve primary closure following extensive wide‐excision. Method With antibiotic prophylaxis, the sinus is excised en‐bloc as a parallelogram (two adjacent rhomboids). Two rhomboid fasciocutaneous flaps are transposed to close this defect over suction‐drains. Sutures are removed after 14 days. Results Eight patients (seven males) were treated with this technique (median age 26 years; range 22–35 years). All had very extensive and recurrent disease, having had multiple previous procedures. Median drain‐duration was 2 days (range 1–5 days) and postoperative stay was 2 days (range 0–5 days). One complication arose: a wound infection with partial dehiscence which healed with conservative treatment. No recurrence or further complication arose in a 33‐month follow‐up (range 8–41 months). Conclusion This is the first description of the use of two simultaneous rhomboid flaps for very large recurrent pilonidal disease. It is a relatively simple and safe alternative to major plastic reconstruction which is often resorted to in such large‐scale disease.