Surgical outcomes of fascio-cutaneous rhomboid transposition flap surgery for pilonidal sinus- A case series
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 6, Issue 1
Abstract
Aims: To analyze the possibility of complications, recurrence on follow-up and time taken to resume routine activity in cases of sacrococcygeal pilonidal sinus treated with fascio-cutaneous rhombic transposition flap repair. Materials and Methods: 10 patients suffering from sacrococcygeal pilonidal sinus were operated upon after elimination of chances of infection. A rhomboid area around the sinus was excised and a flap was created over the area adjacent to the defect and rotated upon its pedicle followed by tension-free suturing of the flap and primary closure of the resulting elliptical defect with placement of a negative-suction drain below the flap. Patients were regularly follow-up till 6 months. Post-operative pain, flap necrosis, collection, resuming of routine activity and recurrence was analysed in these cases. Results: 7 out of 10 patients experienced moderate pain needing intravenous analgesics. Only one patient had undergone flap necrosis with pus collection below the flap and needed debridement and further reconstruction. All other patients had gradually decreasing insignificant amount of drain collection till its removal on 5th post-operative day. Routine activity was resumed after suture removal in 9 out of 10 patients. There were no cases of recurrence in follow-up. Conclusion: Rhombic fascio-cutaneous flap is an effective and easy method of treating sacrococcygeal pilonidal sinus which is an otherwise refractory condition. Careful patient selection and cohort studies are needed to evaluate the risks for flap necrosis.
Authors and Affiliations
Manoj D Togale, Manisha S More, Tanmay B Patravale, S S Shimikore
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