A Comparative Study between Karydakis Procedure versus Rhomboid Excision with Limberg Flap in the Management of Sacrococcygeal Pilonidal Sinus

Introduction: Pilonidal sinus disease is prevalent in young adults and is often linked to factors such as hirsutism and prolonged sitting, which can lead to chronic inflammation in the sacrococcygeal region. Aim: To compare the effects and outcomes of the Karydakis procedure versus Rhomboid excision with Limberg Flap in the treatment of uncomplicated sacrococcygeal pilonidal sinus disease. Material and Methods: This study was conducted at JLN Medical College, Ajmer, from June 2022 to June 2024, and compared the Karydakis flap and Limberg flap surgical techniques. Eighty patients were randomized into two groups: 40 patients who underwent the Karydakis flap and 40 who underwent the Limberg flap. Results: Key outcomes such as operation time, intraoperative blood loss, postoperative complications, pain scores, healing time, and recurrence rates were assessed. The results indicated that both procedures were effective however, the Limberg flap provided better postoperative pain reduction, quicker recovery and fewer complications. Patient satisfaction was also higher with the Limberg flap, particularly in terms of comfort and cosmetic results. Although the Karydakis flap had a shorter operation time, it resulted in longer hospital stays and more postoperative discomfort. Conclusion: This study concluded that the Limberg flap is preferable for faster recovery and better outcomes, and further research is needed for comprehensive validation.