✦ ASYMMETRIC OFF-MIDLINE CLOSURE

Karydakis Flap

Q: How is Karydakis different from Bascom cleft lift?

Both are off-midline techniques with low recurrence. Karydakis uses an asymmetric ellipse with primary closure, while Bascom cleft lift also flattens the entire natal cleft. Choice depends on individual anatomy and disease pattern.

Q: How is recovery after Karydakis flap?

Most patients are discharged in 1 day, return to office work in 1–2 weeks, and avoid heavy strain or prolonged sitting for 4 weeks for complete healing.

Q: Will the wound heal completely?

Yes. Off-midline closure typically heals smoothly over 3–4 weeks with structured wound care, sitz baths and good hygiene.

Q: Can pilonidal sinus come back after Karydakis flap?

Recurrence rates are significantly lower than midline excision and primary closure. Maintaining good hygiene, hair removal in the area, and avoiding prolonged sitting further reduce the chance of recurrence.

Off-midline asymmetric flap closure for pilonidal sinus — flattens the natal cleft and shifts the wound away from the midline, giving low recurrence and excellent healing.

60–90 min PROCEDURE

1 Day HOSPITAL STAY

>90% SUCCESS RATE

1–2 Weeks RETURN TO WORK

What is Karydakis Flap?

The Karydakis Flap is a well-established off-midline technique for definitive pilonidal sinus treatment. The diseased tissue is excised in an asymmetric ellipse, and a flap of healthy tissue is mobilised and advanced to close the wound off the midline. By moving the wound away from the deep natal cleft, the technique significantly reduces the chance of recurrence and supports faster healing. Dr. Tejasree Vengala, an experienced female proctologist in Hyderabad, performs Karydakis flap at Lux Hospitals, Hyderabad, with attention to careful flap planning and durable closure.

Suitable for patients with primary or recurrent pilonidal sinus, those wanting a definitive single-stage procedure with off-midline closure for low recurrence.

How the Procedure Works

Anaesthesia & Planning

Surgery is performed under spinal or general anaesthesia. The diseased area is marked, with planned asymmetric ellipse.

Asymmetric Excision

The sinus and unhealthy tissue are excised in an asymmetric elliptical shape, off to one side of the midline.

Flap Mobilisation

A flap of healthy tissue is mobilised from the lateral side to allow tension-free off-midline closure.

Off-Midline Suturing

The flap is advanced and sutured in layers, placing the final scar off the midline groove.

Drain & Recovery

A small drain is placed if needed. Most patients are discharged the next day with structured wound care.

Outcomes

60–90 minDURATION

1 DayHOSPITAL STAY

>90%SUCCESS RATE

3–4 WeeksFULL HEALING

Who Needs This Treatment?

→Low recurrence rate due to off-midline closure
→Single-stage procedure with primary wound closure
→Faster healing compared to open techniques
→Definitive treatment for primary and recurrent disease
→Quick return to office work in 1–2 weeks
→Excellent functional and cosmetic outcome

Karydakis is a beautifully thought-out operation — the asymmetric design itself is the cure. By placing the scar off the midline, we let the body heal where it can, not where it cannot. It has stood the test of time for very good reasons.

— — Dr. Tejasree Vengala, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

How is Karydakis different from Bascom cleft lift?+

How is recovery after Karydakis flap?+

Will the wound heal completely?+

Can pilonidal sinus come back after Karydakis flap?+

Not sure which treatment is right for you?

Book a consultation with Dr. Tejasree Vengala and get a personalised treatment plan.

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