Outcomes of the house advancement flap for pilonidal sinus.
BACKGROUND
Many surgical techniques have been described for the treatment of pilonidal sinus, yet rates of recurrence and prolonged wound healing remain high and consensus on the optimal technique is lacking. This retrospective study evaluates outcomes of the use of the house advancement flap in the treatment of pilonidal sinus including time to wound healing, sinus recurrence, wound infection and flap necrosis.


METHOD
Thirty-three consecutive patients who underwent excision and house advancement flap for pilonidal sinus, of whom seven patients (21%) had recurrent pilonidal sinus disease following previous surgical intervention, were reviewed retrospectively. Follow-up ranged from 4 to 59 months (mean 28 months).


RESULTS
All 33 patients completed a follow-up survey. Age at time of operation ranged from 14 to 44 years with a mean of 25 years. No patients developed wound infection or flap necrosis. Four patients (12%) failed to achieve primary wound healing; mean time to wound healing for the remaining 29 patients was 62 days. Recurrence of pilonidal sinus occurred in eight patients (24%), at a mean time of 22 months post-operatively.


CONCLUSION
The house advancement flap achieves primary wound closure in almost 90% of cases with few acute post-operative complications. However delayed wound healing and sinus recurrence remain issues with this technique and it appears to have little advantage over other primary closure techniques.
['Mackowski|Alicia|A|', 'Levitt|Michael|M|']
D000293:Adolescent D000328:Adult D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D009336:Necrosis D010864:Pilonidal Sinus D011183:Postoperative Complications D019651:Reconstructive Surgical Procedures D012008:Recurrence D012189:Retrospective Studies D013524:Surgical Flaps D014945:Wound Healing D014946:Wound Infection D055815:Young Adult
pilonidal sinus recurrence wound healing wound infection surgical flap