Karydakis flap for treatment of pilonidal sinus

The treatment of pilonidal sinus still represents a surgical challenge due to the increasing incidence worldwide. A uniform treatment recommendation can currently also not be given. In addition to excision followed by open wound treatment, the asymmetric flap-based procedures and increasingly minimally invasive methods are also available. The latter offer advantages as an outpatient procedure in local anesthesia, duration of surgery and costs; however, flap techniques are still associated with the lowest rates of recurrences. The Karydakis flap is a technically simple operation with very good results in the primary situation as well as wound healing disorders and recurrences. For treatment planning and selection of the operative procedure individual aspects must ultimately be considered in addition to the findings. The frequently still used radical excision with primary open wound treatment should be omitted due to the protracted postoperative course and a high rate of wound healing disorders.