Risk factors for complications and recurrence after the Karydakis flap

BackgroundThis study describes risk factors leading to the development of various postoperative complications and recurrence after the Karydakis procedure.Materials and methodsIn this prospective analytic cohort study, 179 patients with sacrococcygeal pilonidal disease underwent Karydakis procedure. Characteristics of the pilonidal disease and excised ellipse were measured as possible risk factors. Postoperative complications and recurrence were recorded as outcomes.ResultsMultivariate analysis showed that the distance between the last caudal pit and anal verge and length of excised part are independent factors predicting limited superficial skin disruption and infection, respectively. Delayed wound healing was associated with the distance between the last caudal pit and anal verge and history of previous pilonidal surgery. The length of excised part was the only predictor of future recurrence.ConclusionsPatients with no history of previous pilonidal surgery, a short length of extracted part, and long distance of caudal pit from anal verge are best candidates for the Karydakis flap procedure.