• Mehmet Fatih Can, Mert Mahsuni Sevinc, Oguz Hancerliogullari, Mehmet Yilmaz, and Gokhan Yagci.
• Department of Surgery, Ardahan Army Community Hospital, Ardahan, Turkey. mfcan@gata.edu.tr
• Am. J. Surg. 2010 Sep 1;200(3):318-27.

BackgroundThere is still no consensus as to the optimal treatment for sacrococcygeal pilonidal disease (SPD). Many recommend off-midline closure, if any excisional procedure is to be selected.MethodsThe authors prospectively studied 145 patients with SPD who presented at 3 hospitals. Patients were randomly assigned to undergo either modified Limberg flap (MLF) transposition (n = 72) or Karydakis flap reconstruction (n = 73). Surgical findings, complications, recurrence rates, and degree of patient satisfaction, evaluated via a standardized telephone interview, were compared.ResultsOperation time was longer in the MLF group. There were no significant differences between the two groups in terms of complication rate, length of stay, or recurrence rate. Patients in the Karydakis group reported feeling completely healed more quickly postoperatively. The two groups reported similar rates of satisfaction. Mandatory patient withdrawal from a given study arm because of the orifice straying from the midline occurred more frequently in the Karydakis group.ConclusionsThe MLF technique and the Karydakis procedure appear to generate comparable outcomes. With laterally situated orifices, however, the applicability of the Karydakis method may be limited.2010 Elsevier Inc. All rights reserved.

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