Random pattern rotation flaps in the treatment of advanced sacrococcygeal pilonidal disease with damaged skin structure

Abstract

Objective: Various surgical techniques were used to treat advanced sacrococcygeal pilonidal disease. Long learning curve, prolonged surgery and length of hospital stay were observed in most of these methods. In this study, we aimed to present our experience with random pattern rotation flaps in the treatment of sacrococcygeal pilonidal disease with damaged skin structure. Methods: From January 2012 to January 2014, 33 patients were treated with random pattern rotation flaps. Demographic data, body mass index, volume of extracted tissue, width/height ratio of flap, operation time, wound complications and recurrences were evaluated. Results: Patients were 29 (87.8%) male and 4 (12.1%) female with a mean age of 27.8. The mean operative time was 50.1 minutes and length of hospital stay was 1.3 days. The mean width/height ratio was 0.51 and most of the patients (20/60.1%) had a width/height ratio below 0.5. The mean follow-up period was 54.1 months. Two (6.1%) patients had a recurrence and wound complications occurred in three (9.1%) patients. Most of the patients considered the operation as "good" for both health status and aesthetic satisfaction. Although most of the patients' satisfaction of health status was changed as "excellent" on follow-up after one year, there was no statistically significant difference (p=0.37). Conclusion: Random pattern rotation flap is a simple solution in the treatment of pilonidal sinus with damaged skin structure. The short learning curve, short operation time, short length of hospital stay and earlier return to work are seen as the advantages.. Further comparative studies are needed to compare health status and aesthetic outcome.