Which flap-based procedure is used for pilonidal sinus surgery?
Ans. A. Rhomboid flapPilonidal sinus* Pilonidal sinus describes a condition found in the natal cleft near the coccyx, consisting of single or multiple noninfected in the midline.* It is commonly seen in jeep drivers. Therefore, it is also called Jeepers bottom mainly seen at the gluteal cleft.* Seen in young age: 20-29 years.* It is present in the interdigital cleft in hands of a hair dresser, also seen in umbilicus, axilla.* Recurrence rate is very high after surgery.* Excision of all tracks and then closure by some other means designed to avoid a midline wound (Z-plasty, Karydakis procedure, and Limbergs flap).* Bascoms procedure involves an incision lateral to the midline to gain access to the sinus cavity, which is rid of hair and granulation tissue.Flaps and UsesRhomboid flapFor cheek, temple, back, and flat surface defectsTransposition flapThe most basic design, leaving a graftable donor siteAdvancement flapFor flexor surfaces; may need triangles excised at the base to make it work (commonly called Burows triangles)Z-plastyFor lengthening scars or tissuesBilobed flapFor convex surfaces, especially the noseRotation flapFor convex surfacesV-to-Y advancementCommonly used for Fingertips and extremitiesBipedicle flapFor eyelids, rarely elsewhereRhomboid flapTransposition flapZ-PlastyTwo triangular transposition flaps interposedBilobed flapBipedicle flapRotation flap
Rhomboid flap
Rotational flap
Free flap
Circular flap
Plastic & Reconstructive Surgery