Semilunar excision of pilonidal sinus with advancement flap wound closure in the treatment of sacrococcygeal pilonidal disease
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Department of Oncological and General Surgery, University Hospital in Olsztyn, Poland
Department of General and Minimally Invasive Surgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Department of Psychology and Social Sciences in Medicine and Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Department of Anatomy, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Department of Emergency Medicine and Disaster, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
Department of Business, Fresno Pacific University, CA, The United States of America
Łukasz Dyśko   

Department of Oncological and General Surgery, University Hospital in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland. Tel.: +48 89 524 53 41.
Submission date: 2021-07-27
Final revision date: 2021-12-16
Acceptance date: 2021-12-16
Online publication date: 2021-12-27
Sacrococcygeal pilonidal disease is common and had a lot of variants treatment techniques.

This study presents the results of treatment of the pilonidal sinus by the Suchorski method.

Material and methods:
The study was conducted from 2010 to 2017 on 148 patients who underwent Suchorski’s method of wound closure, using the displaced skin-fat flap after the crescent-like excision of the hair sinus in the sacroiliac area. We analyzed length of observation, duration of the surgery, length of hospital stay, complications healing of the surgical wound, duration of pain, number of relapses, disturbances of superficial skin and fat flap sensation, and cosmetic effect.

Results and discussion:
The average follow-up time after surgery was 47 months (12–101 months). During the postoperative period, 11 (7.4%) cases reported complications related to wound healing 8 (5.4%) cases experiencedlimited wound dehiscence, and 1 (0.67%) case showed the wound had completely diverged. Only 2 (1.34%) patients developed a seroma.

The crescent-like excision of the pilonidal sinus of the sacrococcygeal region using the Suchorski’s method is worth recommending, as a modern approach to treating pilonidal disease. This method offers the surgeon the ability to cut not only the small sinuses, but effect large-scale changes and improve patient outcomes.

None declared.
The authors declare that they have no competing interests.
Kanat BH, Sözen S. Disease that should be remembered: Sacrococcygeal pilonidal sinus disease and short history. World J Clin Cases. 2015;3(10):876–879.
Bascom J. Pilonidal disease: Origin from follicles of hairs and results of follicle removal as treatment. Surgery. 1980;87(5):567–572.
Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg. 1992;62(5):385–389.
Abo-Ryia MH, Abd-Allah HS, Al-Shareef MM, Abdulrazek MM. Fascio-Adipo-Cutaneous Lateral Advancement Flap for Treatment of Pilonidal Sinus: A Modification of the Karydakis Operation – Cohort Study. World J Surg. 2018;42(6):1721–1726.
Tokac M, Dumlu EG, Aydin MS, Yalcin A, Kilic M. Comparison of Modified Limberg Flap and Karydakis Flap Operations in Pilonidal Sinus Surgery: Prospective Randomized Study. Int Surg. 2015;100(5):870–877.
Kołodziejczak M, Ciesielski P. Etiopathogenesis and reatment of pilonidal sinus [in Polish]. Post Surg. 2015;1:13–21.
Stauffer VK, Luedi MM, Kauf P, et al. Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence. Sci Rep. 2018;8(1):3058.
Gwynn BR. Use of the rhomboid flap in pilonidal sinus. Ann R Coll Surg Engl. 1986;68(1):40–41.
Suchorski H. Crescent excision of the gluteal gap and plastic with a dislocated lobe in the treatment of the sinus of the sacroiliac region [in Polish]. Mil Dr. 1985;4(2):215–219.
Kose E, Hasbahceci M, Tonyali H, Karagulle M. Comparative analysis of the same technique-the same surgeon approach in the surgical treatment of pilonidal sinus disease: A retrospective cohort study. Ann Surg Treat Res. 2017;93(2):82–87.
AL-Khamis A, McCallum I, King PM, Bruce J. Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev. 2010;2010(1):CD006213.
Arslan S, Karadeniz E, Ozturk G, Aydinli B, Bayraktutan MC, Atamanalp SS. Modified Primary Closure Method for the Treatment of Pilonidal Sinus. Eurasian J Med. 2016;48(2):84–89.
Erkent M, Şahiner İT, Bala M, et al. Comparison of Primary Midline Closure, Limberg Flap, and Karydakis Flap Techniques in Pilonidal Sinus Surgery. Med Sci Monit Int Med J Exp Clin Res. 2018;24:8959–8963.
Isik A, Idiz O, Firat D. Novel Approaches in Pilonidal Sinus Treatment. Prague Med Rep. 2016;117(4):145–152.
Jarmołowicz N, Hortis-Dzierzbicka M, Kukwa A. Dudziński L, Demidowicz R, Grzybowska S. Reconstruction of hard and soft palate with temporalis muscle flap – Case study. Pol Ann Med. 2017;24(2):237–239.
Kartal A, Aydın HO, Oduncu M, Ferhatoğlu MF, Kıvılcım T, Filiz Aİ. Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery. Prague Med Rep. 2018;119(4):148–155.
Lieto E, Castellano P, Pinto M, Zamboli A, Pignatelli C, Galizia G. Dufourmentel rhomboid flap in the radical treatment of primary and recurrent sacrococcygeal pilonidal disease. Dis Colon Rectum. 2010;53(7):1061–1068.
el-Khadrawy O, Hashish M, Ismail K, Shalaby H. Outcome of the rhomboid flap for recurrent pilonidal disease. World J Surg. 2009;33(5):1064–1068.
Sebastian M, Sroczyński M, Rudnicki J. The Dufourmentel modification of the limberg flap: Does it fit all? Adv Clin Exp Med. 2017;26(1):63–67.