better management of chonic pilonidal disease by local flaps

ABSTRACT

The multiplicity of treatment options available for pilonidal disease reflects the general controversy concerning its management. Recurrence unfortunately plagues all forms of therapy, though it is evident that the lowest rates have been reported for procedures involving local flaps. A total of 30 patients with postanal pilonidal sinus were studied. Twenty patients [17 male and 3 female; mean age 25 years] presented by primary pilonidal sinus repaired using transposition rhomboid flap, and 10 patients [9 male and one female; mean age 28 years] presented by complex or recurrent pilonidal sinus repaired using V-Y fasciocutaneous advancement flap. Results shows, uneventful healing occurred in 23 patients within 10 days. Three cases developed transient minor wound dehiscence [one patient [5%] in rhomboid flap and two patients [20%] in V-Y flap] and 4 cases developed superficial wound infection [3 patients [15%] in rhomboid flap and one patient [10%] in V-Y flap]. The maximal inpatient hospital stay was 5 days and the patients returned to their former jobs within 2 weeks postoperatively. There were no recurrence during the follow up period of 6 - 24 months. Both methods are easy to learn and teach, and this study confirms that both methods for reconstruction allows tissue approximation without tension leading to excellent longterm results, minimal discomfort and disability for the patient, early postoperative mobilization and functional rehabilitation and a shorter period of hospital stay