Royal Prince Alfred Hospital
Royal Prince Alfred Hospital
Department of Colorectal Surgery

Colorectal Surgery

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Karydakis Procedure

Pilonidal sinus (small cyst or abscess in the cleft at the top of the buttocks) is a condition more common in men, usually between 15 and 35 years old, and often occurs in people with deep buttock grooves (natal clefts) and short dark hairs.

The Karydakis Procedure is used to treat pilonidal sinus, involving the removal or excision of the abscess with a curved or elliptical technique to one side of the midline (lateral) of the buttocks. A flap  is then created of skin and fat from the deeper layers of one side and closed to the other side, with a drain commonly used in this procedure. The procedure results in a wound that is lateral to the midline, with a shallower natal cleft.

The procedure may be day only or require an overnight stay, depending on your doctor and whether a drain is used.

Many modifications of the Karydakis Procedure exist, because there are no perfect results. Wounds may break down and some need partial or full dressings, and pilonidal sinus may reoccur in three to five per cent of cases.

A number of alternate treatments for pilonidal sinus exist such as marsupialisation, secondary healing, V-Y advancement flat, Z-plasty, Limberg flap, Rhomboid flap and Bascom procedure.


Reviewed 2017