Suhail Anjum, Naveed Jabbar, Jamil Ahmed.
Comparision of Excision and Primary (Midline) Closure with Karydakis Technique in the Surgical Treatment of Pilonidal Sinus.
Annals Punjab Med Coll Jan ;7(2):148-53.

Pilonidal sinus is a common anorectal problem that occurs in the cleavage between the buttocks (natal cleft) and causes discomfort and embarrassment & absence from work for the sufferers. It typically affects young men and women. Numerous surgical procedures have been described but treatment failure and disease recurrence is common leading to considerable morbidity in these otherwise healthy patients. Objective: To compare the effectiveness of excision and primary closure with Karadykis Technique of cleft closure in the surgical treatment of pilonidal sinus. Materials and Methods: Setting: Department of Surgery, Ch. Rahmat Ali Memorial Hospital, Township, Lahore. Study Duration: 3 years (Jan 2009 to Dec 2011).  Sample Size: 40 patients, 20 in each group. Inclusion Criteria: All adult males and females with clinical diagnosis of chronic pilonidal sinusExclusion Criteria: Recurrent pilonidal sinus disease, acute pilonidal abscess. Results: Out of 40 patients, 35 (87.5%) were males and 5 (12.5%) were females. Age range was 16 to 35 years with mean age of 25.5 years. Group A consisted of 20 patients who underwent Excision and Primary closure while group B had 20 patients who underwent Karydakis Technique of cleft closure. The postoperative complications encountered in Group A were post operative pain, wound infection, numbness at the site of surgery and recurrence while in Group B, complications included post operative pain, hematoma/seroma formation, wound infection, wound dehiscence, numbness at the site of surgery and recurrence. Conclusion: Karadykis procedure is better than excision and primary midline closure in terms of less postoperative complications, reduced hospital stay and recurrence rate.

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