The Dufourmentel flap in pilonidal disease. Case series and literature review.

Abstract

Introduction: Pilonidal disease is a pathology that affects the sacrococcygeal region produced by the entry of hair into the subcutaneous tissue. It presents a prevalence (26/100,000), predominantly in young adults and in males with a 2.2:1 ratio.

There are different surgical techniques, among which the closure of the defect outside the midline stands out, one of which is the use of dermocutaneous flaps.

The objective is to analyze a series of patients, the treatment used and bibliographic update.

Material and methods: Based on a retrospective database of 40 patients operated on for a sacrococcygeal cyst, between January 2020 and January 2021 at Hospital Naval Puerto Belgrano, 10 patients who underwent radical resection with offline primary closure were extracted. median with Dufourmentel flap. Preoperative body mass index (BMI), hospital stay, postoperative pain, dehiscence, flap necrosis, surgical site infection, and return to work activities were evaluated.

Results: 8 corresponded to the male sex and 2 females with ages between 16 and 27 years (21.5); 1 recurred on 2 occasions, 1 recurred on 1 opportunity, 7 cases with prior drainage treatment plus antibiotic therapy, 1 associated with perianal fistula.

Average operating time 55 minutes. Mean hospital stay 1 day, in all cases a counter-opening drainage was left, withdrawn between the 4th and 7th postoperative day, presenting 30% of postoperative complications of dehiscence, necrosis of the upper edge of the flap, granuloma and surgical site infection, resuming the work tasks between 17 and 30 days pop, reporting minimal pain. No recurrences during 12-month follow-up.

Discussion: The treatment of the pilonidal cyst is diverse, thus having different surgical and non-surgical techniques. In this series, the versatility of the Dufourmentel dermocutaneous flap as a reconstructive technique for primary closure of the defect outside the midline is demonstrated.