Evidence map›Paper›PMID 42311045›Full record

Observational studyWorld journal of surgery2026

Karydakis Versus Limberg Flap in Primary Sacrococcygeal Pilonidal Sinus: A Retrospective Comparative Study of Functional Recovery.

Tamer A A M Habeeb, Abdulzahra Hussain, Jose Bueno-Lledó, Mariano Eduardo Giménez, Alberto Aiolfi, Ahmed Abdelsamad, Massimo Chiaretti, Igor A Kryvoruchko, Mallikarjuna N Manangi, Nasreldin Mohammed Algalaly and 46 more

Registry-linked trialAbstract readComparative StudyMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07271537 (Outcomes of Karydakis Versus Limberg Flap for the Management of Primary Sacrococcygeal Pilonidal Sinus), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07271537 completednot on this map

Outcomes of Karydakis Versus Limberg Flap for the Management of Primary Sacrococcygeal Pilonidal Sinus

TypeobservationalSponsorZagazig UniversityRan2017 to 2024Enrolled352ConditionsPilonidal Cyst and Sinus Without AbscessArmskarydakis surgery, Limberg flap
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

56 authors.

Tamer A A M HabeebDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Abdulzahra HussainSheffield University, Sheffield, UK.ORCID https://orcid.org/0000-0001-9956-0291
Jose Bueno-LledóHospital Universitari i Politècnic la Fe, Valencia, Spain.
Mariano Eduardo GiménezUniversity of Strasbourg, Strasbourg, France.
Alberto AiolfiDivision of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Milan, Milan, Italy.
Ahmed AbdelsamadDepartment of Surgery II, University of Witten/Herdecke, Witten, Germany.ORCID https://orcid.org/0000-0002-5451-4504
Massimo ChiarettiDepartment of General Surgery Specialties and Organ Transplant, Faculty of Pharmacy and Medicine, Sapienza Rome University, Rome, Italy.
Igor A KryvoruchkoDepartment of Surgery No.2, Kharkiv National Medical University, Kharkiv, Ukraine.ORCID https://orcid.org/0000-0002-5525-701X
Mallikarjuna N ManangiDepartment of General Surgery, Bengaluru, India.
Nasreldin Mohammed AlgalalyGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohammed AbbasGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed Fathy LabibGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Osama AlmezaienGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID https://orcid.org/0000-0002-3683-2584
Mohamed Hassan Mohamed ElkaseerGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hamada Rashad Mohamed AbdelkaderGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed SwelamGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mahmoud E NagatyGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mahmoud Abd Alhady Abd Alaziz Abd AlhadyGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed Ibrahim HenishGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hamdy FaragGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed Ibrahim ShalameshGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ibtsam AbdElMaksoud Mohamed El ShamyDepartment of General Surgery, Faculty of Medicine for Girls, Cairo Al Azhar University, Cairo, Egypt.
Alaa A FiadDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Hamdi ElbelkasiMataryia Teaching Hospital (GOTHI), Cairo, Egypt.
Mohamed Ibrahim Abo AlsaadGeneral Surgery Department-Faculty of Medicine, Merit University, Sohag, Egypt.
Mahmoud Moustafa Al-ShareefDepartment of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mahmoud Abdelnasser EissaDepartment of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mahmoud Elghonimy Abd ElsadekDepartment of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.
Abouelatta K H AliMisr University for Science and Technology, Cairo, Egypt.
Maged Z YoussefDepartment of General Surgery, Faculty of Medicine, October 6 University, 6th of October City, Egypt.
Mohamed Abdelbar MohamedDepartment of General Surgery, Faculty of Medicine, Luxor University, Luxor, Egypt.ORCID https://orcid.org/0009-0008-1680-4624
Ahmed HamdyDepartment of Hepato-Bilio-Pancreatic (HBP) Surgery, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Ali Hussein KhedrDepartment of Surgery National Hepatology and Tropical Medicine Research Institute (-NHTMRI), Cairo, Egypt.
Ayman A KhaterDepartment of General Surgery, Faculty of Medicine, Benha University, Benha, Egypt.
Hazem E AliDepartment of General Surgery, Faculty of Medicine, Benha University, Benha, Egypt.
Mohammed SiamDepartment of General Surgery, Faculty of Medicine, Suez University, Suez, Egypt.
Mohamad Naeem ElnahasPlastic Surgery Department, Faculty of Medicine, Shebin Teaching Hospital, Menoufia, Egypt.
Mohamed Adel SaqrPlastic and Reconstructive Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mostafa Fathy Ibrahim AhmedPlastic Surgery Department, Faculty of Medicine, Benisuef University, Beni Suef, Egypt.
Mohamed Mahmoud Mokhtar MohamedDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mohamed ElnemrDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Bassam MousaDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.ORCID https://orcid.org/0000-0002-4622-9295
Tamer WasefyDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Ahmed M El TelitiDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mohamed AbozaidDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Adel MorsiDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Taha A BiomyDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Baher AtefDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mohamed Mahmoud AlmeniawyDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mohamad S MoussaDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mohamed H HebeishyDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Hasnaa MetwallyDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mohamed S BayomiDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Abdelshafy MostafaDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Ahmed Attia SalehDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Mahmoud Abdou YassinDepartment of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Funding

Science and Technology Development Fund
6 · The paper itself

Abstract

backgroundSuccessful surgical management of pilonidal sinus disease (PSD) in young, active patients requires rapid restoration of daily functions, including driving and sexual activity. This study compared patient-reported recovery as regards sexual function and driving ability following the KF versus the LF for primary sacrococcygeal PSD.

methodsThis multicenter retrospective cohort study (FLARE study) included employed, sexually active patients who underwent surgery for primary PSD (July 2017-July 2024). The primary outcome was time to sexual activity resumption; the secondary outcome was time to resumption of driving. Outcomes were assessed at 1 year using a structured Likert-scale questionnaire. Kaplan-Meier curves and Cox regression analyses with adjustment were used.

resultsA total of 352 patients were divided into 176 KF and 176 LF. KF patients resumed sexual activity earlier (2.88 ± 0.7 vs. 4.58 ± 1.1 weeks; mean difference -1.7 weeks, 95% CI -1.89 to -1.49, p < 0.001). KF reported significantly less pain, less avoidance, and lower analgesic use during sex. LF reported lower sexual satisfaction (mean 3.94 vs. 2.15; mean difference -1.78, 95% CI -2.02 to -1.53). KF resumed driving earlier (median 9 vs. 19 days; r = 0.7, large effect, p < 0.001) and had longer sitting tolerance (OR 0.3, 95% CI 0.2-0.4, p < 0.001). LF had higher pain while sitting (mean Likert 4 vs. 2; mean difference of -1.94, 95% CI -2.19 to -1.68), higher VAS pain (median 4 vs. 2; r = 0.5), greater need for cushions/analgesics, and more driving-related work/social limitations (all p < 0.001). Time to resume sexual activity and driving was significantly shorter for KF. On multivariable analysis, LF was independently associated with delayed return to sexual activity (adjusted OR 4.02, 95% CI 2.1-7.5, p < 0.001) and delayed return to driving (adjusted OR 2.8, 95% CI 1.5-5.2, p < 0.001).

conclusionsIn this retrospective cohort, KF may be associated with significantly faster return to sexual and driving activity compared with LF. These results underscore the importance of incorporating patient-centered functional outcomes into surgical decision-making for PSD.

trial registrationNumber: NCT07271537.

Indexed as

Pilonidal SinusRecovery of FunctionSurgical FlapsAdultFemaleHumansMaleRetrospective StudiesSacrococcygeal RegionSexual BehaviorTreatment OutcomeYoung Adultdriving abilitykarydakis flaplimberg flappilonidal sinusrecurrencesexual activity

Identifiers

PMID42311045
PMCPMC13460901

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Registered trials

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