Karydakis procedure

Pilonidal sinus is a condition more common in males, usually between 15 and 35 years old, and often occurs in people with deep natal clefts and short dark hairs. Patients may present with an abscess, a sinus or a fistula.

The Karydakis Procedure is used for the cure of pilonidal sinus when it is appropriate. It was developed by a Greek surgeon, Dr. George Karydakis, and involves an elliptical excision around the disease using an ellipse that is lateral, meaning to one side of the midline of the natal cleft. A flap is then created of skin and fat off the deeper layers of only one side, and the flap and wound is closed on the same side as on which the axis of the excision ellipse was placed. A drain is commonly used under that flap also. The procedure results in a wound that is lateral to the midline, with a shallower natal cleft.

The procedure may be day only or require an overnight stay, depending on your doctor and whether a drain is used.

Many modifications of the Karydakis Procedure exist, because there are no perfect results. Wounds may break down is some, partially or fully and require dressings, and pilonidal sinus may reoccur in 3 to 5%.

Many alternate treatment for sacrococcygeal (natal cleft) pilonidal sinus exist, including marsupialisation, secondary healing, V-Y advancement flat, Z-plasty, Limberg flap, Rhomboid flap and Bascom procedure.

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