Rauf Sheikh, Khalid Ahsan Malik, Shafiq Ur Rehman.
Outcome of surgery for Pilonidal sinus: Karydakis versus open procedure.
Pak J Surg Jan ;23(3):202-4.

Objective. To compare and analyze the outcome of Karydaki`s procedure with Open excision technique for Pilonidal sinus, especially in terms of recovery time, period off work, complications and recurrence. Design & Duration: Prospective, randomized and comparative study from April 2004 to Sept. 2006. Setting. Dept. of Surgery (Unit -I), Sindh Government Lyari General Hospital, Karachi. Patients: Twenty six patients with Pilonidal sinus of the natal cleft were included in the study. Methodology. Biodata, symptoms and signs of all the patients were recorded and appropriate investigations performed. They were randomized into two groups. Group-K underwent Karydakis procedure in which a wedge of tissue including the sinus and its ramifications were excised with primary asymmetrical closure of the wound. In Group-0 patients, wide excision of the Pilonidal sinus tract was done and the wound was left open. Result: Amongst the 26 patients included in the study, majority (25) were males in the third decade of life (53.85%). Their mean duration of symptoms was 8.52 months. The mean operating time for K- Group (45±10 mins) cases was a bit longer than the O-Group patients (25±5 mins.). However the former group was associated with fewer postoperative complications, lesser recovery period (2.46 weeks), lesser period off-work (3.53 weeks) and low recurrence rate (7.69%). In contradiction, amongst the 0-Group patients the mean recovery period was 6.69 weeks, mean period off-work was 8.15 weeks and recurrence was seen in 15.38% patients. Conclusion: The Karydakis procedure is superior to Open excision in terms of post-operative morbidity, recurrence rate and recovery period, though it takes a bit longer to perform.

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