Application of fasciocutaneous V-Y advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease
Ismail Demiryilmaz, Ismail Yilmaz, Kemal Peker, Fehmi Celebi, Orhan Cimen, Arda Isik, Senol Bicer, Deniz Firat
Department of General Surgery, Erzincan University, Erzincan, Turkey
Med Sci Monit 2014; 20:1263-1266
Pilonidal sinus disease is a common disease of young adults, which most frequently occurs in the sacrococcygeal region on the skin’s midline. Various procedures, ranging from simple incision and curettage to complex flaps for natal cleft obliteration, have been described in the literature.
Material and Methods: We aimed to present the dermographic characters, post-operative complications, length of stay in hospital, time of return to daily activities, and recurrence rates of the patients in which we applied sinus excision and fasciocutaneous V-Y advancement flap due to primary complicated or recurrent sacrococcygeal pilonidal sinus disease.
Results: Patients with primary complicated and recurrent pilonidal sinus received a fasciocutaneous V-Y advancement flap in the general surgery service of our hospital. Eleven patients had recurrent disease. Thirty-seven patients received a unilateral V-Y flap and 8 patients received a bilateral V-Y flap. None of the patients had post-operative flap necrosis or wound opening. Two of the patients had a self-draining simple seroma and 3 of the patients had delayed wound healing in the perianal region of the incision, which was treated with dressing. The mean time required to return to daily activities was 7 days, and return to work took 17 days. In the mean 25-month follow-ups of the patients, no recurrences were detected.
Conclusions: We think that fasciocutaneous V-Y advancement flap is an easily learned and practicable method that reduces the recurrences in the patients with primary complicated and recurrent pilonidal sinus, length of stay in hospital, and time to return to daily activities and work in the post-operative period.
Keywords: Adult, Length of Stay, Pilonidal Sinus - surgery, Postoperative Complications - physiopathology, Reconstructive Surgical Procedures - methods, Recurrence, return to work, Sacrococcygeal Region - surgery, Surgical Flaps, Wound Healing - physiology