Learning Curve for Pilonidal Sinus Surgery: The Best Option for Budding Surgeons.

Abstract

Surgery for pilonidal sinus has no gold standard, and results depend purely on surgeon preference of procedure and experience. Till date, there has been no study comparing the surgical outcomes when performed by residents. Therefore, we designed our study to compare the short-term outcomes of Karydakis' and Limberg's flap procedures in the treatment of pilonidal disease when performed by surgical residents. A prospective, double-blinded, observational study was carried out at Command Hospital, Pune, India. Twenty-five consecutive patients undergoing each of the Karydakis' and Limberg's flap procedures (n = 50) were enrolled in the study. All patients had a primary sinus opening. Patients with a frank pilonidal abscess were excluded, but patients with history of intermittent purulent discharge even during time of surgery were included. There was a significantly higher rate of infection in the Karydakis' group (9/25) as compared to the Limberg's flap group (3/25) and also a higher rate of complete wound dehiscence (2/25 vs 1/25). Limberg's flap procedure appears to be superior to Karydakis' procedure, and the results are reproducible even by budding surgeons with little experience in the procedure.