✦ OFF-MIDLINE CLOSURE

Karydakis Flap

Q: Is Karydakis Flap better than Limberg Flap for pilonidal sinus?

Both have excellent outcomes. Karydakis involves less tissue mobilisation and a lower complication rate. Limberg Flap may be preferred for larger defects or recurrent disease after prior surgery.

Q: How long before I can return to work after Karydakis Flap?

Most patients return to desk work in 2-3 weeks. Physical work and prolonged sitting is avoided for 4 weeks. Full unrestricted activity resumes at 4-6 weeks.

Q: Is laser hair removal necessary after Karydakis Flap?

Laser hair removal around the scar and natal cleft post-operatively significantly reduces recurrence by eliminating the ingrown hair trigger. Dr. Samhitha strongly recommends this as part of the complete treatment plan.

Q: What is the pilonidal sinus surgery cost in Hyderabad?

Pilonidal sinus surgery including Karydakis Flap is covered by most health insurance plans at Lux Hospitals, Hyderabad. Contact us for a detailed out-of-pocket estimate.

An asymmetric elliptical excision and flap advancement that moves the healed scar away from the natal cleft midline - significantly reducing pilonidal sinus recurrence. A cornerstone of minimally invasive pilonidal sinus treatment in Hyderabad.

<5% RECURRENCE RATE

2-3 Weeks RECOVERY

Off-Midline CLOSURE

Low COMPLICATION RATE

What is Karydakis Flap?

The Karydakis Flap uses an asymmetric off-centre elliptical excision of the pilonidal sinus followed by a medialisation advancement flap - moving the wound closure to one side of the midline. This simple but highly effective principle eliminates the moist, hairy midline environment that predisposes to recurrence. Dr. Samhitha Reddy performs the Karydakis Flap at Lux Hospitals, Hyderabad as a primary or secondary procedure for pilonidal sinus, offering an excellent balance of simplicity, low recurrence (<5%), and faster recovery. It is one of the most recommended pilonidal sinus treatment options in Hyderabad for both primary and recurrent disease.

Active abscess must be fully drained and resolved before the Karydakis Flap is performed. Post-operative laser hair removal significantly reduces recurrence by eliminating the hair ingrowth trigger.

How the Procedure Works

Asymmetric Elliptical Excision

An asymmetric ellipse is marked to one side of the midline, encompassing all sinus pits and tracts. Excision is taken down to the presacral fascia.

Flap Mobilisation

The medial skin and subcutaneous flap is mobilised from the lateral aspect, preserving its blood supply.

Flap Advancement & Fixation

The flap is advanced medially. Its deep surface is sutured to the presacral fascia - medialisation ensures the wound closes off-midline.

Skin Closure

The skin is closed with vertical mattress or subcuticular absorbable sutures. A suction drain is placed for 24-48 hours in larger excisions.

Post-operative Care

Hospital stay 1 day. Wound checked at 7 and 14 days. Laser hair removal around the scar advised at 6 weeks. Return to work in 2-3 weeks.

Outcomes

<5%RECURRENCE RATE

2-3 WeeksRECOVERY

Off-MidlineCLOSURE

LowCOMPLICATION RATE

Who Needs This Treatment?

→Very low recurrence rate (<5%) - superior to midline primary closure
→Off-midline closure eliminates the moist midline environment that promotes re-infection
→Primary wound closure - faster healing than open excision (2-3 weeks vs 6-8)
→Low complication rate - wound breakdown occurs in <5% of cases
→Simple, reproducible technique with an excellent evidence base
→Available at Lux Hospitals, Hyderabad with post-operative laser hair removal advice

The Karydakis operation is wonderfully practical - simple to learn, reproducible to perform, and with impressive long-term results. The key insight of moving the scar off the midline is elegant in its simplicity and highly effective in its impact.

— - Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon

Common Questions

Frequently Asked

Is Karydakis Flap better than Limberg Flap for pilonidal sinus?+

How long before I can return to work after Karydakis Flap?+

Is laser hair removal necessary after Karydakis Flap?+

What is the pilonidal sinus surgery cost in Hyderabad?+

Not sure which treatment is right for you?

Book a consultation with Dr. Samhitha Reddy and get a personalised treatment plan.

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