UNILATERAL ASYMMETRICAL Z- PLASTY INCLUDING PRESACRAL FASCIA FOR RECONSTRUCTION OF SACROCOCCYGEAL PILONIDAL DEFECT: CLINICAL EVALUATION

Abstract

Background: Pilonidal disease frequently occurs in adults and is characterized by a significant rate of recurrence, leading to discomfort for the affected cases. The aim of this work is to evaluate the results of ellipse excision of sacrococcygeal pilonidal sinus and reconstruction of the defect with a unilateral unequal Z-plasty at the upper third part defect.Patients and methods: The study involved 50 patients who were diagnosed with sacrococcygeal pilonidal sinus. They underwent an ellipse excision of the sacrococcygeal pilonidal sinus, followed by the reconstruction of the excised area using a unilateral unequal Z-plasty at the upper third of the defect. A follow-up period of 6 months was observed. Data on surgical outcomes, any complications, rate of recurrence, and patient's satisfaction levels were recorded and analyzed.Results: The study included 50 participants, comprising 45 men and 5 women, with a median age of 23.7 years (ranging from 18 to 37 years). Healing of the wound occurred within the first two weeks for both primary and subsequent occurrences, with an average healing time of 14 days (ranging from 10 to 30 days). Two patients (4%) experienced postoperative infections, which were treated with wound dressing, appropriate antibiotics, and extended drainage. The length of hospital stay varied from 1 to 2 days, and the average duration before patients could return to work was 12 days (ranging from 10 to 17 days). After an average follow-up period of 6 months, recurrences were observed in three cases (6%)Conclusion: Unilateral unequal Z-plasty provides a simple healthy and well vascularized flap that fits and fills the defect following pilonidal sinus excision.