Gluteal fasciocutaneous rotational flap and its role in the management of complex sacrococcygeal pilonidal sinus disease: a case-series study

Background
Complex sacrococcygeal pilonidal disease is an aggressive disease that requires a wide excision of the whole natal cleft and all involved tissues. This extensive excision results in a defect that is not pliable for primary closure. Reconstruction of the defect by an ideal flap is a practical option.
Objective
This study aimed at assessing the feasibility and the efficacy of the gluteal fasciocutaneous rotational flap in the management of complex sacrococcygeal pilonidal sinus disease.
Patients and methods
During the period from April 2018 to March 2020, 40 patients with complex sacrococcygeal pilonidal sinus disease presented to the General Surgery Department, Benha University Hospital, for management of this complex disease. All the patients underwent complete excision of the disease and reconstruction of the defect by a gluteal fasciocutaneous rotational flap.
Results
The study group included 40 patients. The mean age±SD was 27.03±7.26. Five (12.5%) patients had recurrent disease. The mean operative time was 55.0±8.16 min. All patients were discharged within 24 h postoperatively. The mean time to return to normal daily activities was 2.55±0.68 days, whereas the mean time to return to work was 2.91±0.87 weeks, and the mean follow‐up was 14.95±3.2 months (range, 10.0–18.0 months). One (2.5%) patient had a recurrence in the second year of the follow‐up.
Conclusion
Gluteal fasciocutaneous rotational flap is a feasible, simple, and reliable method for reconstruction of a wide defect after excision of a complex sacrococcygeal pilonidal sinus disease.