Karydakis flap

The original Karydakis flap consisted of an elliptical semilateral excision of midline pits and the nearby secondary sinus with the cephalad and caudal apices being 2cm from the midline1.

A full-thickness flap was sutured to the sacrococcygeal fascia. Later, Karydakis added a second layer of deep sutures2.

Kitchen proposed a thinner flap3 and Anderson displaced the caudal apex 3cm from the midline4.


top view of excision


 excision and flap


cross section excision


cross section flap


cross section end result



1. Karydakis GE. New approach to the problem of pilonidal sinus. Lancet 1973;2:1414-5.

2. Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg 1992;62:385-9.

3. Kitchen PR. Pilonidal sinus: experience with the Karydakis flap. Br J Surg 1996;83:1452-5.

4. Anderson JH, Yip CO, Nagabhushan JS, Connelly SJ. Day-case Karydakis flap for pilonidal sinus. Dis Colon Rectum 2008;51:134-8.