Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지

Surgical Treatment of Sacrococcygeal Pilonidal Sinus with the Partial Deepithelized Gluteal Transposition Flap

부분 탈상피화 둔부 전위 피판을 이용한 천미골 털둥지굴의 수술적 치료

  • Nam, Doo Hyun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Shin, Ho Seong (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Park, Eun Soo (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Yong Bae (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University)
  • 남두현 (순천향대학교 의과대학 성형외과학교실) ;
  • 신호성 (순천향대학교 의과대학 성형외과학교실) ;
  • 박은수 (순천향대학교 의과대학 성형외과학교실) ;
  • 김용배 (순천향대학교 의과대학 성형외과학교실)
  • Received : 2008.03.31
  • Accepted : 2008.05.21
  • Published : 2008.07.10
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Abstract

Purpose: Pilonidal sinus is a frequent disease that occurs mostly in hairy young men, defined as chronic inflammation and infection of the postsacral sinuses. Wide excision of the affected area is the treatment of choice. Many techniques have been described to cover the defect. However none appears to be the ideal procedure to prevent infection, recurrence, and delayed wound healing. We present the results of an alternative technique that we performed by using partial deepithelized gluteal transposition flap for reconstruction of the defect following wide excision. Methods: From October 2004 to September 2007, we performed the partial deepithelized gluteal transposition flap method on 6 patients. We modified the transposition flap techniques by deepithelialising the medial parts of the flap and burying them under the opposing edge of the flap. The results were compared with previous studies and evaluated regarding duration of surgery, size of defect, hospitalization periods, and complications. Results: All the flaps were healed well with no partial or complete loss of the flap. Hospitalization and immobilization periods were acceptably shortened. Recurrence was not seen. The aesthetic outcome was also satisfactory and all patients were satisfied with the results. Conclusion: The main advantage of our techniques is using healthy tissues to obliterate the dead space, to provide an extra-cushion, and to prevent deep dehiscence. We believe that the partial deepithelized gluteal transposition flap is a good alternative method for treatment of pilonidal sinus.

Keywords

References

  1. Kim SM, Shin JM, Choi SJ, Kim SM: MR Imaging of sacrococcygeal pilonidal Sinus. J Korean Radiological Soc 43: 615, 2000 https://doi.org/10.3348/jkrs.2000.43.5.615
  2. Milito G, Cortese F, Casciani CU: Rhomboid flap procedure for pilonidal sinus: result from 67 cases. Int J Colorectal Dis 13: 113, 1998 https://doi.org/10.1007/s003840050146
  3. Khatri VP, Espinosa MH, Amin AK: Management of recurrent pilonidal sinus by simple V-Y fasciocutaneous flap. Dis Colon Rectum 37: 1232, 1994 https://doi.org/10.1007/BF02257787
  4. Middleton MD: Treatment of pilonidal sinus by Z-plasty. Br J Surg 55: 516, 1968 https://doi.org/10.1002/bjs.1800550706
  5. Johnson, HA: On treatment of pilonidal sinus and cysts by conservative excision and W-plasty closure. Plast Reconstr Surg 62: 107, 1978 https://doi.org/10.1097/00006534-197807000-00020
  6. Perez-Gurri JA, Temple WJ, Ketcham AS: Gluteus maximus myocutaneous flap for the treatment of recalcitrant pilonidal disease. Dis Colon Rectum 27: 262, 1984 https://doi.org/10.1007/BF02553803
  7. De Silva JH: Pilonidal cyst: cause and treatment. Dis Colon Rectum 43: 1146, 2000 https://doi.org/10.1007/BF02236564
  8. Sungur N, Kocer U, Uysal A, Arslan C, Cologlu H, Ulusoy G: V-Y Rotation advancement fasciocutaneous flap for excisional defects of pilonidal sinus. Plast Reconstr Surg 117: 2448, 2006 https://doi.org/10.1097/01.prs.0000219170.74059.94
  9. Wheeland RG: Pilonidal sinus and cyst. cutaneous surgery. 1st ed, Philadelphia, WB Saunder, 1994, p 659
  10. Spivak H, Brooks VL, Nussbaum M, Friedman I: Treatment of chronic pilonidal disease. Dis Colon Rectum 39: 1136, 1996 https://doi.org/10.1007/BF02081415
  11. Rosen W, Davidson JS: Gluteus maximus musculocutaneous flap for the treatment of recalcitrant pilonidal disease. Ann Plast Surg 37: 293, 1996 https://doi.org/10.1097/00000637-199609000-00010
  12. Bascom J: Pilonidal diasease: origin from follicles of hairs and results of follicle removal as treatment. Surgery 87: 567, 1980
  13. Al Hassan HK, Francis IM, Neglen P: Primary closure or secondary granulation after excision of pilonidal sinus? Acta Chir Scand 156: 695, 1990
  14. Tuncbilek G, Nasir S, Ozkan O, Kayikcioglu A, Mavili E: Partial de-epithelialised and buried V-Y advancement flap for reconstruction sacrococcygeal and ischial defects. Scand J Plast Reconstr Surg Hand Surg 38: 94, 2004 https://doi.org/10.1080/02844310310006431