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.
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.