Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap

Venus,; Titley, O. Garth

doi:10.1308/003588412x13171221499748

Cited by 15 publications

(12 citation statements)

References 26 publications

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“…Various surgical options have been developed for the reconstruction of sacral defects, and since Koshima et al first described perforator flaps in 1993, [ 5 ] several designs have been suggested to treat pressure ulcers. [ 3 , 4 , 6 , 12 ] The main advantage of perforator flaps is that they enable a longer pedicle and a greater arc of rotation while maintaining the gluteus maximus muscle, and coverage of large defect areas using remote flaps. However, harvesting of a long pedicle is cumbersome, and isolation of the vessel poses a risk of vascular injury, which can lead to venous congestion or arterial ischemia and jeopardize flap survival.…”

Section: Discussionmentioning

confidence: 99%

“…The sacrococcygeal area has many perforating vessels on which flaps may be raised, [ 5 , 12 ] and design changes depend on which perforating vessel is selected and defect shape. Here, we report our experiences selecting a perforator based on considerations of relaxed skin tension lines (RSTLs) that have provided efficient flap designs that enable primary closure.…”

Section: Introductionmentioning

confidence: 99%

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Designing with relaxed skin tension line in perforator-based island flap for sacral sore reconstruction: A STROBE-compliant observational study

Kwon¹,

Ahn²,

Kim³

et al. 2022

Medicine

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Many various types of operative techniques have been performed used to treat make-up for sacral defects. Perforator-based flaps with flap transposition, but achieving an optimal flap design and tension-free flap closure without skeletonizing the perforator requires a great deal of clinical experience. In this study, we demonstrate perforator selection based on considerations of the relaxed skin tension line (RSTL), which has proven to be a suitable method of achieving an efficient flap design that enables primary closure. Twenty-five perforator-based flap procedures were performed on 25 patients at a single institution from February 2018 to January 2021. The medical records of patients were retrospectively reviewed. Twenty-three flaps survived completely. Two flaps developed partial tip necrosis but recovered after secondary healing, and 1 patient developed temporary congestion, which resolved spontaneously. No recipient or donor site recurrence or dehiscence was identified during follow-up. We report our clinical experiences of perforator-based flap use in the sacral region. When selecting an appropriate perforating vessel, 2 important points should be considered, that is, a flap long axis parallel to RSTLs and defect shape. According to the method presented in this paper, perforator-based flaps can be transposed safely and easily with few complications and serve as useful practice models to cover sacral defects.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Designing with relaxed skin tension line in perforator-based island flap for sacral sore reconstruction: A STROBE-compliant observational study

Kwon¹,

Ahn²,

Kim³

et al. 2022

Medicine

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“…Of all the surgical procedures, the local flaps fill the defect, avoid a midline scar, provide tension free closure and can flatten the natal cleft and thereby offer advantages over direct closure techniques [17].…”

Section: Discussionmentioning

confidence: 99%

Rhomboid Flap vs. Keystone Perforator Island Flap (KPIF) in the Treatment of Pilonidal Sinus Disease: Comparison of Short-Term Results

Roatis¹,

Georgescu²

2020

IJCM

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Background: Pilonidal disease is a chronic inflammatory disease of the sacrococcygeal region that mainly affects young people. Its incidence is 26 cases per 100,000 persons. Although many techniques have been described, there is no consensus on the treatment of pilonidal sinus disease (PSD). Materials and Methods: This study included 30 patients with PSD who were treated between May 2014 and September 2017. All cases underwent excision and flap reconstruction. The operative time, postoperative complications, the length of hospital stay, painless sitting and walking time, patient satisfaction and recurrence were evaluated prospectively. Results: The results of this prospective, randomized and comparative study are based on experience of a single surgical centre. All patients were followed up 18 months after discharge from the hospital. There is a difference in surgery durations (minutes) between the two groups (33.86 ± 2.89 min. in "keystone" flap vs. 41.26 ± 4.19 in the "rhombic" flap group) (p = 0.001). There were no significant differences in the length of hospital stay, painless sitting and walking time or patient satisfaction. The total complication rate was 66.6% after rhomboid flap compared with 6.6% after keystone flap. There was no flap necrosis. Conclusions: Both of these methods have shown to be successful in treatment of PSD. The KPIF is associated with the advantages of very simple design, abundant blood supply from the perforator vessels and lower rate of complication.

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“…The most accepted theory postulated that PNS is an acquired condition characterized by infected sinus in the 361 natal cleft area contains lifeless hair tuft [3]. There are multiple techniques prescribed for its treatment however the ideal method still not yet defined [4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Combined Horizontal Split Gluteus Maximus Muscle Flap and Fasciocutaneous Limberg Flap for Reconstruction of Recurrent Sacrococcygeal Pilonidal Sinus

Ahmad

2020

The Egyptian Journal of Plastic and Reconstructive Surgery

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Background: Pilonidal sinus is a chronic recurrent medical disease. The exact etiology of the disease is still unknown but the most accepted theory is an acquired condition characterized by infected sinus in the natal cleft area contains lifeless hair tuft. Multiple techniques were prescribed for its treatment however the ideal method still not yet defined. Patients and Methods: Fifty eight male patients who underwent excision of their recurrent pilonidal sinus disease and the resulting defects were reconstructed using combined horizontal split gluteus maximus flaps and rhomboid flaps. Outcomes were revised from patient's files case and followed up in outpatient clinic and via questionnaires. Results: The mean hospital stay was three days. The mean time to return to work was 16 days. Partial wound dehiscence's occurred in two patients. Distal end flap necrosis occurred in one patient. There were no flap losses, no recurrences, no infections, no loss of function and no seromas during a mean follow-up period of 24 months. All patients were satisfied with the results. Conclusion: In comparison with other techniques, it has a comparable operative time and hospital stays. It has minimal and acceptable complication rates and no recurrences. We can conclude that this procedure of combined split gluteus maximus muscle flap and rhomboid flap provides an excellent, effective, easy and feasible method of choice for reconstructing defects of recurrent pilonidal sinus disease.

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Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap

Cited by 15 publications

References 26 publications

Designing with relaxed skin tension line in perforator-based island flap for sacral sore reconstruction: A STROBE-compliant observational study

Designing with relaxed skin tension line in perforator-based island flap for sacral sore reconstruction: A STROBE-compliant observational study

Rhomboid Flap vs. Keystone Perforator Island Flap (KPIF) in the Treatment of Pilonidal Sinus Disease: Comparison of Short-Term Results

Combined Horizontal Split Gluteus Maximus Muscle Flap and Fasciocutaneous Limberg Flap for Reconstruction of Recurrent Sacrococcygeal Pilonidal Sinus

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