"Flag Excision and Flap" Procedure: a Novel Modification for Off-Midline Closure After Pilonidal Sinus Excision

Yucel E., Tezcan L., Yilmaz O. C., Akin M. L.

INDIAN JOURNAL OF SURGERY, vol.77, 2015 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 77
  • Publication Date: 2015
  • Doi Number: 10.1007/s12262-015-1241-8
  • Journal Name: INDIAN JOURNAL OF SURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Keywords: Pilonidal sinus, Flag excision, Flap, Off-midline closure, RANDOMIZED CLINICAL-TRIAL, LIMBERG FLAP, FOLLICLE REMOVAL, DISEASE, MANAGEMENT
  • Dokuz Eylül University Affiliated: No

Abstract

Pilonidal sinus surgery has evolved with the novel flap techniques, and off-midline closure became a preferred surgical procedure due to shorter recovery time and low recurrence rates. To obtain a better off-midline closure without maceration and a possible wound problem, we modified a novel excision technique. We aimed to present this novel flag modification of rhomboid excision and flap reconstruction experience. From December 2007 to June 2009, 100 patients were treatedwith flag excision and flap reconstruction under regional anesthesia and followed with a mean of 42 (range 35-55) months. Competent closure results were obtained successfully in all patients without an overlap between incision line and midline. None of the patients had seroma. Two patients (2 %) had partial wound detachment superiorly. None of the patients had recurrence during follow-up. The flag excision and flap reconstruction procedure is an effective and comfortable technique both for the surgeon and the patient with a quick healing period and low complication rates without maceration.