Karydakis Procedure vs Limberg Flap in the Treatment of Saccrococcygeal Pilonidal Sinus

Abstract

Objective:To compare differences in the outcomes between these two techniques.
Methods: This was a randomized controlled trial conducted in the Services Institute of Medical
Sciences, Lahore from August 2017 to August 2018. A total of 60 patients were enrolled in the
study. Patients were randomly allocated in the two groups. In group A, pilonidal sinus was treated
with karydakis procedure. In the group B, pilonidal sinus as excised with limberg flap. Patients
were then followed on 7th day, 14th day, 1 month, 6 month and 18 months after the surgery to
evaluate the postoperative results.
Results: The mean age of the patients was 28.65±10.58 years. 58 patients were males and 2
patients were females. The mean BMI of the patients was 23.83±3.26 kg/m2. The mean duration
of surgery was 40±8 mins in karydakis procedure and 55±10 min in limberg flap (p=0.02). The
mean pain score (VAS) in karydakis group was 4.83±1.34 while it was 4.10±2.30 in limberg group
(p=0.141). The mean hospital stay in karydakis group was 2.72±0.80 days whereas the mean
hospital stay in limberg group was 4.45±0.92 days (p=0.000). Wound infection developed in 2
(6.67%) patients following karydakis procedure and in 1(3.33%) patient after limberg flap with pvalue of 0.346. The mean time for wound healing in case of karydakis group was 14.93±2.79 days
while it was 12.42±2.36 days. In the study, 4/30(13.33%) patients in karydakis group presented
with recurrence and 2/30 (6.67%) patients in limberg group developed recurrence with p-value of
0.344.
Conclusions: It was concluded that there was shorter hospital stay in karydakis procedure and
shorter healing time in limberg flap however there was no statistically significant difference in
postoperative pain, wound complications and recurrence in these two procedures.