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Application of fasciocutaneous V-Y advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease.

Demiryilmaz I, Yilmaz I, Peker K, Celebi F, Cimen O, Isik A, Bicer S, Firat D - Med. Sci. Monit. (2014)

Bottom Line: Two of the patients had a self-draining simple seroma and 3 of the patients had delayed wound healing in the perianal region of the incision, which was treated with dressing.The mean time required to return to daily activities was 7 days, and return to work took 17 days.In the mean 25-month follow-ups of the patients, no recurrences were detected.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Erzincan University, Erzincan, Turkey.

ABSTRACT

Background: Pilonidal sinus disease is a common disease of young adults, which most frequently occurs in the sacrococcygeal region on the skin's midline. Various procedures, ranging from simple incision and curettage to complex flaps for natal cleft obliteration, have been described in the literature.

Material/methods: We aimed to present the dermographic characters, post-operative complications, length of stay in hospital, time of return to daily activities, and recurrence rates of the patients in which we applied sinus excision and fasciocutaneous V-Y advancement flap due to primary complicated or recurrent sacrococcygeal pilonidal sinus disease.

Results: Patients with primary complicated and recurrent pilonidal sinus received a fasciocutaneous V-Y advancement flap in the general surgery service of our hospital. Eleven patients had recurrent disease. Thirty-seven patients received a unilateral V-Y flap and 8 patients received a bilateral V-Y flap. None of the patients had post-operative flap necrosis or wound opening. Two of the patients had a self-draining simple seroma and 3 of the patients had delayed wound healing in the perianal region of the incision, which was treated with dressing. The mean time required to return to daily activities was 7 days, and return to work took 17 days. In the mean 25-month follow-ups of the patients, no recurrences were detected.

Conclusions: We think that fasciocutaneous V-Y advancement flap is an easily learned and practicable method that reduces the recurrences in the patients with primary complicated and recurrent pilonidal sinus, length of stay in hospital, and time to return to daily activities and work in the post-operative period.

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Related in: MedlinePlus

Complete unilateral fasciocutaneous V-Y flap.
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f4-medscimonit-20-1263: Complete unilateral fasciocutaneous V-Y flap.

Mentions: All the operations were carried out by the same surgeon and under spinal anesthesia. After spinal anesthesia, the patients were positioned face downwards for surgery, and the surgical area was cleaned with povidone-iodine after shaving. The presacral fascia was reached by injection of methylene blue through each sinus opening and using cautery with ellipsoid incision embodying all the sinus openings, and the skin was totally excised with subcutaneous tissues (Figure 1). In accordance with the width of the defect, unilateral or bilateral fasciocutaneous V-Y flap (Figure 2) (unilateral ones through the left gluteal region) was set free by being passed cutaneously and subcutaneously in the shape of a triangle (as the top of the triangle is right and/or left gluteus lateral, the base of the triangle is ellipsoid incision) and being mobilized by being lifted towards medial, with the fascia over flap gluteal muscle in the shape of an islet formed after reaching gluteal fascia at the top and the bottom by being bonded at the vertex of the triangle (Figure 3). The whole of this triangle-shaped mobile fasciocutaneous flap was covered with subcutaneous Vicryl no.1 and cutaneous 2/0 Prolene medially (Figure 4). The patients were received 1 g. Cefamezin preoperatively and postoperatively. The patients were ordered to avoid sitting until their sutures were removed, to take short steps, and use a depilatory on the surgical region for about 2 months after removal of the sutures. The patients were examined 1 month and 6 months after the operation by being called for the control examination. In the subsequent periods, the patients were followed-up every 6 months by phone.


Application of fasciocutaneous V-Y advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease.

Demiryilmaz I, Yilmaz I, Peker K, Celebi F, Cimen O, Isik A, Bicer S, Firat D - Med. Sci. Monit. (2014)

Complete unilateral fasciocutaneous V-Y flap.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4114698&req=5

f4-medscimonit-20-1263: Complete unilateral fasciocutaneous V-Y flap.
Mentions: All the operations were carried out by the same surgeon and under spinal anesthesia. After spinal anesthesia, the patients were positioned face downwards for surgery, and the surgical area was cleaned with povidone-iodine after shaving. The presacral fascia was reached by injection of methylene blue through each sinus opening and using cautery with ellipsoid incision embodying all the sinus openings, and the skin was totally excised with subcutaneous tissues (Figure 1). In accordance with the width of the defect, unilateral or bilateral fasciocutaneous V-Y flap (Figure 2) (unilateral ones through the left gluteal region) was set free by being passed cutaneously and subcutaneously in the shape of a triangle (as the top of the triangle is right and/or left gluteus lateral, the base of the triangle is ellipsoid incision) and being mobilized by being lifted towards medial, with the fascia over flap gluteal muscle in the shape of an islet formed after reaching gluteal fascia at the top and the bottom by being bonded at the vertex of the triangle (Figure 3). The whole of this triangle-shaped mobile fasciocutaneous flap was covered with subcutaneous Vicryl no.1 and cutaneous 2/0 Prolene medially (Figure 4). The patients were received 1 g. Cefamezin preoperatively and postoperatively. The patients were ordered to avoid sitting until their sutures were removed, to take short steps, and use a depilatory on the surgical region for about 2 months after removal of the sutures. The patients were examined 1 month and 6 months after the operation by being called for the control examination. In the subsequent periods, the patients were followed-up every 6 months by phone.

Bottom Line: Two of the patients had a self-draining simple seroma and 3 of the patients had delayed wound healing in the perianal region of the incision, which was treated with dressing.The mean time required to return to daily activities was 7 days, and return to work took 17 days.In the mean 25-month follow-ups of the patients, no recurrences were detected.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Erzincan University, Erzincan, Turkey.

ABSTRACT

Background: Pilonidal sinus disease is a common disease of young adults, which most frequently occurs in the sacrococcygeal region on the skin's midline. Various procedures, ranging from simple incision and curettage to complex flaps for natal cleft obliteration, have been described in the literature.

Material/methods: We aimed to present the dermographic characters, post-operative complications, length of stay in hospital, time of return to daily activities, and recurrence rates of the patients in which we applied sinus excision and fasciocutaneous V-Y advancement flap due to primary complicated or recurrent sacrococcygeal pilonidal sinus disease.

Results: Patients with primary complicated and recurrent pilonidal sinus received a fasciocutaneous V-Y advancement flap in the general surgery service of our hospital. Eleven patients had recurrent disease. Thirty-seven patients received a unilateral V-Y flap and 8 patients received a bilateral V-Y flap. None of the patients had post-operative flap necrosis or wound opening. Two of the patients had a self-draining simple seroma and 3 of the patients had delayed wound healing in the perianal region of the incision, which was treated with dressing. The mean time required to return to daily activities was 7 days, and return to work took 17 days. In the mean 25-month follow-ups of the patients, no recurrences were detected.

Conclusions: We think that fasciocutaneous V-Y advancement flap is an easily learned and practicable method that reduces the recurrences in the patients with primary complicated and recurrent pilonidal sinus, length of stay in hospital, and time to return to daily activities and work in the post-operative period.

Show MeSH
Related in: MedlinePlus