rhomboid flap for recurrent pilonidal disease

ABSTRACT

Pilonidal sinus is a common chronic disease of the sacrococcygeal region. The treatment varies according to the clinical presentation of the disease. Although many surgical methods have been suggested, an ideal method is still lacking because of high recurrence rates. Recurrent disease causes significant morbidity particularly with time off work. The aim of this work is to assess the rhomboid flap's role in promoting primary healing in recurrent pilonidal disease and to evaluate the morbidity and recurrence. This prospective study included 40 patients [32 males and 8 females] who were treated with the use of a rhomboid flap closure for recurrent sacrococcygeal pilonidal sinus at Tanta University Hospital from Januray 2000 to October 2006. The follow-up period ranged from 06 months to 07 years. There were 32 males and 8 females with a median age of 18 years [range 16-38 years]. The mean hospital stay was 06 days [range, 05-11 days]. Two patients had to be hospitalized for two weeks due to superficial wound infection that recovered with injectable antibiotics. The mean time to return to work after discharge from the hospital was 15 days [range, 12-26 days]. Post-operative morbidity involved superficial wound infection in 4 patients [10%]. There were four recurrences [10%]. Six patients [15%] had numbness over the flap and four patients [10%] were not pleased with cosmetic appearance of the scars. The results favor rhomboid flap closure in the treatment of recurrent sacrococcygeal pilonidal sinus, especially with multiple recurrences and in patients with extensive involvement. Lower recurrence rates, shorter hospital stay, and time off work may outweigh the disadvantages related to unfavorable cosmetic appearance