Modified Karydakis flap - Lateral advancing flap

The flap should be created first, usually 2 cm wide and 0.5 cm deep. The skin flap should be gently pulled across the midline with skin hooks to determine if the outer rim of the "ellipse" has been made correctly on the skin. The ellipse should include all sinuses.

References:

Karydakis GE. New approach to the problem of pilonidal sinus. Lancet 1973; 2:1414.
Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative processes. Aust NZ J Surg 1992; 62:385.
Bascom J, Bascom T. Failed pilonidal surgery: New paradigm and new operation leading to cures. Arch Surg 2002; 137:1146.
Kitchen PR. Pilonidal sinus: Excision and primary closure with a lateralised wound - The Karydakis operation. Aust N Z J Surg 1982; 52:302.

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Modified Karydakis flap - Lateral advancing flap