A Comparative Study between Excision and Reconstruction Using Superior Gluteal Artery Perforator Flap and Lay Open in Cases of Recurrent Pilonidal Sinuses

Abstract Background: Pilonidal sinus (PS) remains a problem for the surgeon and nuisance to the patients. Pilonidal sinus disease is a small hole or tunnel in the skin at the top of the buttocks, where they divide (the natal cleft) usually seen in Young adults and carries high post-operative morbidity and patient discomfort. Complicated pilonidal surgical wounds are associated with considerable morbidity, including chronic sacral wound, loss of work time, and lifestyle limitation. Aim of Study: To compare between two surgical methods, excision of the recurrent pilonidal sinus and covering the defect using SGAP flap and lay open. Patients and Methods: After approval of the ethical committee in Ain Shams University, El-Demerdash Hospital, the current study was done between August 2020 and Septem-ber 2021. Informed consent forms from all patients were obtained. It was a prospective study including 40 patients diagnosed with recurrent PNS disease presented to the surgery and plastic clinics of Ain Shams University Hospitals and Nasser Institute Hospital. Results: Comparison between cases of SGAP flap and cases of Lay open regarding the healing indicated that 100% of SGAP flap cases have good healing while 85% of the lay open cases have good healing, such findings were not statis-tically significant (p-value >0.05). Comparison between cases of SGAP flap and cases of Lay open regarding the infection indicated that 100% of SGAP flap cases have no infection while 50% of the lay open cases have infection, such findings were statistically significant (p-value <0.05). Regarding wound dehiscence between cases of SGAP flap no statistically significant differences (p-value >0.05), 10% of the SGAP flap cases have dehiscence. Comparison between cases of SGAP flap and cases of Lay open regarding recurrence indicated a statistically significant increase in recurrence among the Lay open cases 20% in comparison with the SGAP flap cases 0% (p-value <0.05). Regarding the flap complica-tions among cases of SGAP flap, the present study revealed that 20% of the SGAP flap cases have congestion and 80% have no complications.
Conclusion: The comparison between two techniques in management of the recurrent pilonidal sinus, showed that no surgical procedure satisfies the principal requirements of an ideal treatment and each technique has advantages and disad-vantages.