Outcomes of Karydakis Flap Procedure for Primary Pilonidal Sinus Disease at a Teaching Hospital in Pakistan: A Prospective Study of a Single-Arm Surgical Intervention

Background: Pilonidal sinus disease (PSD) of natal cleft is a long-term illness characterized by a blind epithelial tract containing hair, commonly affecting young males with excessive body hair. Various surgical techniques have been developed to treat PSD, yet no universally accepted standard exists.Objective: To evaluate the clinical outcomes of the Karydakis flap procedure in patients who were diagnosed with primary natal cleft pilonidal sinus disease.Methods: This research was carried out at a teaching hospital in Lahore, Pakistan in which 100 patients suffering from primary sacrococcygeal pilonidal sinus disease underwent Karydakis flap procedure. Patient data, including procedure duration, hospital stay, postoperative pain levels, wound infection rates, seroma formation, flap necrosis, and recurrence, were systematically recorded and analysed using SPSS version 21.0.Results: The results demonstrated favourable outcomes, with an 86% primary healing rate. The average procedure time was 47.50 ± 5.14 minutes, and the average length for hospitalization was 1.87 ± 0.80 days. Postoperative pain was measured by using the Visual Analog Scale (VAS), which had a mean score of 3.45. Surgical site infections were observed in 8% of cases, while 6% experienced seroma formation. No case of flap necrosis was reported, and disease recurrence occurred in only 2% of patients within six months.Conclusion: Karydakis flap procedure is a reliable and effective surgical approach for treating primary pilonidal sinus disease of the natal cleft. Its design supports faster recovery, minimal postoperative issues, and reduced recurrence, making it a preferred option in clinical practice.