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Mid-line Excision Versus Karydakis Operation for Pilonidal Sinus

This study has been completed.
County Council of Norrbotten, Sweden
Norrlandstingens Regionförbund
Information provided by (Responsible Party):
Markku Haapamaki, Umeå University Identifier:
First received: December 15, 2006
Last updated: May 31, 2016
Last verified: May 2016
The trial compares excision in the midline at surgery for pilonidal disease versus excision lateral of the midline (Karydakis operation) at surgery for pilonidal disease by randomly allocating patients with pilonidal disease to two groups of surgeons, each group being trained for one of the two methods.

Condition Intervention Phase
Pilonidal Sinus
Procedure: Surgery for pilonidal disease, midline excision
Procedure: Surgery for pilonidal disease, Karydakis operation
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Expertise-based Randomized Controlled Trial Comparing Midline Excision Versus Karydakis Operation at Surgery for Pilonidal Sinus

Further study details as provided by Umeå University:

Primary Outcome Measures:
  • time to complete wound healing [ Time Frame: one year or until reoperation ]

Secondary Outcome Measures:
  • health-related quality of life [ Time Frame: one year ]
  • time needed returning to normal physical activity after operation [ Time Frame: one year or until reoperation ]
  • days spent on sick-leave [ Time Frame: one year or until reoperation ]
  • health care costs and total costs [ Time Frame: one year ]
  • postoperative wound infection rate [ Time Frame: one year or until reoperation ]
  • recurrence rate [ Time Frame: one year or until reoperation ]

Enrollment: 125
Study Start Date: March 2006
Study Completion Date: March 2016
Primary Completion Date: March 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Midline excision
Midline excision for pilonidal sinus disease.
Procedure: Surgery for pilonidal disease, midline excision
A midline excision is made for the treatment of pilonidal sinus disease.
Active Comparator: Karydakis
Karydakis operation for pilonidal sinus disease.
Procedure: Surgery for pilonidal disease, Karydakis operation
A Karydakis operation is done for the treatment of pilonidal sinus disease.

Detailed Description:

Excision in the midline and primary suture is a long proven method of treating pilonidal sinus. However it's associated with high incidence of post operative infection and recurrence. On the other hand Karydakis operation (excision lateral of the midline, transposition flap and primary suture) is just a slightly more complicated procedure but has five times less recurrences reported in case series. The purpose of the present study is to compare the surgical results and costs of the two surgical methods utilized. In addition the investigators aim to compare the quality of life at defined time points after surgery. Eligible patients are randomized to two groups of surgeons, well trained in either the midline operation or the Karydakis operation (expertise based design). The design of the study allows wide inclusion criteria for participants, a cost-utility approach in the analysis, and a high external validity of the conclusions reached.

Comparison: Midline excision andd primary suture compared with the Karydakis operation (excision lateral of the midline and primary suture) for pilonidal disease.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age 18 years or older.
  • Surgery is considered the best available treatment.
  • The patient understands trial information and is capable of making a decision for informed consent after having received information.
  • The patient wants to undergo surgery for pilonidal sinus and accepts participation in the trial.

Exclusion Criteria:

  • Patient has had a pilonidal abscess during the last four weeks before the planned day of surgery
  • Patient has had surgery (excision) for pilonidal sinus more than once before.
  Contacts and Locations
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Please refer to this study by its identifier: NCT00412659

Sunderby Regional Hospital
Luleå, Sweden, SE 972 80
Umeå University Hospital
Umeå, Sweden, SE 90185
Sponsors and Collaborators
Umeå University
County Council of Norrbotten, Sweden
Norrlandstingens Regionförbund
Principal Investigator: Christoffer Odensten, MD County Council of Norrbotten, Sweden
Principal Investigator: Markku M Haapamaki, MD, PhD Umeå University
Study Chair: Peter Naredi, MD, Ph D Umeå University
Study Director: Michael Dahlberg, MD, PhD County Council of Norrbotten
  More Information

Responsible Party: Markku Haapamaki, Associate professor, MD, PhD, Umeå University Identifier: NCT00412659     History of Changes
Other Study ID Numbers: PSIN-05-178M
Study First Received: December 15, 2006
Last Updated: May 31, 2016

Keywords provided by Umeå University:
Sinus, Pilonidal
Pilonidal sinus
Pilonidal cysts
Pilonidal disease
midline excision
Karydakis operation
expertise based study

Additional relevant MeSH terms:
Pilonidal Sinus
Neoplasms processed this record on April 21, 2017