Outcome of Rhomboid Flap and Z-Plasty in Pilonidal Sinus Surgery

Abstract

Background
 There are controversies about the etiology and management of pilonidal sinus. The numbers of techniques are testament in treating pilonidal sinus (PNS) and no single procedure is superior in all aspects.
 Objectives
 The Purpose of this study was to evaluate two operative procedures regarding its complications including recurrences of the disease.
 Methods
 The medical records of 40 patients in whom the Rhomboid Flap and Z-Plasty techniques were applied for reconstruction after the excision were evaluated retrospectively.
 Results
 The incidence rates of postoperative hematoma 1 (2.5%), wound infection 3 (7.5%), seroma 1 (2.5%), sinus formation 1 (2.5%) and neurological symptoms 17 (42.5%) activities were achieved after a mean of 21.20 days. During the average follow-up of 24 months, three patients (7.5%) developed recurrent disease.
 Conclusion
 Rhomboid flap and Z-plasty technique are flattening of the natal cleft, thus reducing local recurrence rates. Hence, we recommend use of flap technique for pilonidal sinus patients; Z-plasty is cosmetically more accepted as it has less postoperative complication.

Intermammary pilonidal sinus: The first case series

“…Excision with primary closure is another alternative surgical therapy. The latter has the advantage of early cure rate, less job absence, more patient satisfaction and being less costly [20] . All surgical therapies put the patient at risk of morbidity and long time work absence, so they don’t seem to be ideal management strategy [13] .…”

“…Not like sacrococcigeal PNS, iPNS has least technical problem with primary closure. The former needs flap for which countless techniques have been proposed in the literature [20] . However, flap has never been recommended for primary closure of iPNS.…”

Pilonidal sinus of breast, a case report with literature review

“…A preferable surgical therapy includes excision with primary closure, which is more reliable than the previous one due to less time consumption, positive cure rate, less costs, and more patient satisfaction [ 12 ]. Non-operative therapies like phenol injection, laser therapy, and ointment sometimes can be used but some studies reported recurrence, failure, and complication development after phenol injection [ [13] , [14] , [15] ]. Some studies encourage treatment with surgical therapy (excision and primary closure) due to recurrence after aspiration and medical treatment or slow response of the abscess to antibiotics [ 1 , 10 ].…”