Modified bascom procedure. In a recent retrospective study by Khodakaram et al. Information, treatments, and support for Pilonidal Disease patients and medical professionals . 5 months (minimum of 18 months), 20 patients (91%) reported a good or excellent functional outcome as A prospective randomized controlled trial of simple Bascom’s technique versus Bascom’s cleft closure in the treatment of chronic pilonidal disease. P. The suggested modified Bascom technique is an attractive, safe, easily performed Aim: Bascom's cleft-lift procedure for pilonidal sinus disease under tumescent local analgesia is feasible and well tolerated with favourable short-term outcomes. John Bascom Sacred Heart Medical Center Eugene, OR 97405, USA. The goal of this procedure is to remove all of the diseased tissue and obliterate the cleft with an off-midline flap creation. yasu. This doctor is completely unpredictable. The thickness of the excised tissue and of the mobilized flap is only 2–3 mm and the The modified Bascom cleft lift technique is effective and reliable. Karydakis flap and Modified Bascom are two promising surgical techniques. I was back home three hours later. 5) avoids any excision of the abscess or secondary openings. Reported wound dehiscence rates vary from 0% to 45% (33, e10) and they also decreased after the modified procedure . " I strongly advise anyone to avoid him at all costs. Methods: Patients with Twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. 04. As you work on designing a new database or assume administrative and development responsibilities for a currently existing database, you are likely to need to track and monitor the performance of many object types in a database, including stored procedures. Arch Surg 2002;137(10):1146–50. The cost of a flap proce-dure, ranging from $10,000 to $30,000, is greater than the cost of excision or other conservative therapy. Failed pilonidal surgery: New paradigm and new operation leading to cures. 011. This study presents the res Modification of the Bascom cleft lift procedure for chronic pilonidal sinus: results in 141 patients - Guner - 2013 - Colorectal Disease - Wiley Online Library With the Bascom cleft-lift flap, an elliptical incision is made from the midline pits to the lateral side of a previously demarcated safety zone, with an off midline flap created on the opposite side. Surgery, 121 (3) (1997), pp. Log in with Facebook Log in with Google. When presented with an acute abscess, our technique is to drain the abscess laterally, a finger’s width off the midline (STAY OUT OF THE DITCH!) Once the abscess is open, drained and scrubbed out, When I asked about follow-up care or a plan to address my ongoing issues, he became angry and offered no solutions, eventually telling me to leave. Am J Surg. retrospectively compared this method with WLE and healing by secondary intention, and noted lower recurrence rates for the Bascom Background: Many options are available for treatment sacrococcygeal pilonidal sinus disease either surgical or medical, but surgery is preferred. 1016/j. BACKGROUND The objective of this study is to compare the effectiveness of The modified Bascom cleft lift technique is effective and reliable. Indeed, there was expected post-surgical aftermath but I quickly was back to normal and, most In a study of 218 day surgery patients treated with Bascom's procedure, Definite surgical treatment of complicated recurrent pilonidal disease with a modified fasciocutaneous V-Y advancement flap. C. After an international surgical training, I am now based in Rome, Italy. Solution. Bascom J, Bascom T. Dudnik R, Veldkamp J, Nienhujis S, et al. E. If the abscess wall is rigid, it is “cubed” to allow it to collapse. Is the flap closure included in the procedure described by code 11772, Excision of pilonidal cyst or sinus; complicated, or should code 14000, Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less, be reported in addition to code 11772? Comparison of Modified Limberg Flap and Karydakis Flap Operations in Pilonidal Sinus Surgery: Prospective Randomized Study Our study found out that short and long-term results of the MLF and KF procedures are similar. He gave me fantastic insight into the research of it all whilst guiding me to surgeons who could benefit me. The modified Bascom procedure combines elements of both excision and flap techniques. Hamdy Shahat; View full-text. The duration of this procedure was This is just one of many ways to repair a pilonidal. My experience was terrible—he lied about the procedure and had the nerve to call it a "modified Bascom. For that reason, in my opinion, the terms Pilonidal Disease: mini-invasive Bascom's procedure (Bascom J. These procedures include rhomboid flaps, Z-plasty, the Karydakis procedure (see above), Bascom’s cleft lift procedure, V-Y plasty, gluteus maximus myocutaneous flaps, and skin grafting (Table 15-1). Two hundred fifty-seven patients with sacrococcygeal pilonidal sinus disease treated with the Karydakis flap procedure between December 2003 and June 2011 at the 5th General Surgery Clinic of Istanbul Haydarpasa Numune Training and Research Hospital were evaluated with respect to age, gender, duration of preoperative symptoms, a This procedure is a modification of the Bascom pit picking procedure, and it was described by Dr. Kitchen's 88, 89 and Bascom's 25, 26, 83 modifications of the Karydakis technique use thinner skin flaps and the Bascom ‘cleft lift’ procedure avoids any excision of the abscess or the modified Karydakis procedures such as the Bascom cleft lift operation, which avoids wide excision of the abscess, flattens the cleft and is increasingly The Bascom cleft lift procedure (group B) was performed as described by Bascom and Bascom [4, 9]. Here we present the case of recurrent pilonidal disease treated with a Bascom cleft lift procedure. Patients and methods: From April 2014 to July 2018, 150 patients with Patients and methods: From April 2014 to July 2018, 150 patients with Bascom's cleft-lift (CL) procedure is relatively simple to perform compared with other off-midline procedures, and CL has been shown to be associated with acceptable risk of postoperative complications, a high rate of wound healing and low recurrence rates even in a day-surgery setting [5-8]. More studies with larger group of patients are needed especially in recurrent cases to come to Find a surgeon who specializes in Pilonidal Disease surgery from our lists, particularly Bascom Cleft Lift surgeons. The Bascom cleft lift technique has been reported to produce successful results. This procedure (which is also Explore the treatment options for Pilonidal Cystectomy / Excision. & Cripps, N. With this procedure, the midline pits as well as the skin from the diseased side of the natal cleft are removed. With the cleft lift procedure, Bascom modified the asymmetric closure and lateralization of the wound proposed by Karydakis and Kitchen. Patients and methods: From March 2022 to The cleft-lift procedure finds its origins in a precursor operation developed by Greek surgeon G. His hard work, insight, and excellent judgment led Limberg flap versus Bascom cleft lift techniques for sacrococcygeal pilonidal the Bascom cleft lift procedure is a reliable technique that provides shorter operation duration and better quality of life Secondary healing versus midline closure and modified Bascom natal cleft lift for pilonidal sinus disease In July, Dr. or reset password. Easley DEFINITION Lateral ankle injuries are among the most common musculoskeletal injuries in the athletic population. Case Report: We present a case of a 29-year-old male with recurrent pilonidal disease underwent a modified Bascom cleft lift technique which is a rotation flap procedure with an off-midline Over the past three decades with the intent of lateralizing and flattening the natal fissure, while providing a healthy tissue coverage of the defect without the risk of tension in the suture line, procedures based on the off-center flap (Limberg, Karidakis, “clift left”) “modified Bascom technique and ZV flaps” have been shown to This study presents the results of a modified cleft lift procedure in which the sinus tissue was excised and the lower end of the incision was kept outside the intergluteal sulcus by extending the lowerEnd of theincision laterally. Aquí nos gustaría mostrarte una descripción, pero el sitio web que estás mirando no lo permite. AdventHealth Medical Group Colorectal If you hear the term “Bascom procedure” with no other context, then it probably refers to pit picking; if you hear the term “Bascom II” then it refers to the cleft lift. Flap-based procedures remain an option, particularly in cases of complex and recurrent chronic pilonidal disease when other techniques have failed Lazaris AC, Tahteris E, Panoussopoulos D. 21,22 Majeski et al, 23 treated 127 patients with Bascom technique and reported recurrent disease in 3 patients at 1-year follow-up or sooner. Messages 25 Location Sierra Vista, AZ Best answers 0. Article Details. com/ We would like to show you a description here but the site won’t allow us. Objectives: The aim of this study is to evaluate early postoperative outcomes and satisfaction of patients with Pilonidal Sinus (PNS) who underwent either Karydakis flap or Modified Bascom Cleft Lift Procedure at our Department. Modified Bascom`s Assymetric Closure Technique for Recurrent Pilonidal Disease Vol 46, No 9, Dis Colon Rectum, Sep 2003 2. Was wondering if any of Cleft Lift Flap (Bascom Procedure) The cleft lift flap , also known as the Bascom procedure, is (Hurley stage, modified Sartorius scores, and HS Physicians Global Assessment) and patient-reported outcomes (visual analogue pain scale, dermatology life quality index, and work productivity and activity impairment questionnaire). Methods The records of all the patients who underwent pilonidal sinus excision between November 2013 and August 2017 were reviewed. SQL Server stored procedures can implement vital functions within a database. This procedure (which is also called “cleft-closure”) has become his procedure of choice because of his high success rate — even in patients who have had multiple previous operations. 4±7 years. Password. It involves the excision of the sinus followed by the creation of a lateral incision to remove the midline cleft. When examining pooled data from 21 RCTs, Karydakis and Bascom’s procedure had an overall recurrence rate of 2. Modified Karydakis Pilonidal Surgery. Arch Surg. Dis Colon Conclusion: Modified Bascom natal cleft lift is associated with good outcome, it is simple procedure and easy to learn, with early mobilization, short hospital stay early return to daily modified by Bascom and Kitchen [5,7-9]. The cleft lift method is a modification of the Karydakis procedure , described by Bascom . Over the 10-year study period, a total of 63 patients met the inclusion criteria with 18 patients undergoing wide excision with OMF reconstruction (Bascom cleft lift flap n = 10, MLF n = 8) and 45 patients undergoing the EPSiT procedure. We aimed to assess the 10‐year treatment success rate after cleft‐lift under tumescent local analgesia. Modified Cleft-Lift. Full-text available. 2002 Oct. Bascom's cleft‐lift procedure for pilonidal sinus disease under tumescent local analgesia is feasible and well tolerated with favourable short‐term outcomes. Group A (25) patients underwent modified Bascom procedure and group B (19) patients underwent excision and midline closure. Pilonidal disease is a recurring problem frequently affecting young people. In conclusion, modified Bascom procedure is feasible, effective and applicable for all patients with pilonidal sinus, and of particular advantages in the treatment of complex, recurrent and chronic non-healing pil onidal sinuses when wound healing remains an important dilemma in the surgical treatment. excision and primary closure, Bascom procedure, Karydakis flap procedure (KF), or sinus excision and skin flap methods, such as Limberg flap rotat ion (LF), Z plasty flap a nd modified Limber g flap. There is no definitive consensus on the best treatment for pilonidal sinus. The terminology and variations of the Europe PMC is an archive of life sciences journal literature. 34 When fibrin glue was used as a monotherapy compared with Bascom's procedure there was low‐quality evidence to support less pain on day one after the procedure and shorter time to return to Bascom procedure. Secondary openings of the abscess well away from the midline do not Nordon, I. Karydakis in the early 1970s. 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. A Bascom procedure (cleft lift procedure A modified version keeps the apices of the incision away from the midline. A prospective randomized controlled trial of simple Bascom’s technique versus Bascom’s cleft closure in the treatment of chronic pilonidal disease. 2009;197:189-192. Hecht Justin S. Overall, the differences may be unimportant within the grand scheme of things, because Dr. Authors Izi Obokhare 1 , Robert C Amajoyi 2 Affiliations 1 Texas Tech Health Sciences Center, 1400 In order to avoid median recurrences and flatten the natal cleft, surgeons have developed numerous procedures such as the Karydakis technique [3,23,24], Bascom procedure, modified Bascom [18,25 The modified Bascom technique with primary closure and advancement flap for the treatment of complex pilonidal disease showed effective for this case of recurrent pilonidal disease. Reported wound dehiscence rates vary from 0% to 45% (33, e10) and they also decreased after the modified procedure Bascom T: Utility of the cleft lift procedure in refractory pilonidal disease. S. There were no demographical differences between the groups of patients. , Senapati, A. Please suggest CPT code for excision of pilonidal cyst? 11770 or 11771? GayathriR says: August 5, 2019 at 3:32 am. Modified Bascom's asymmetric midgluteal cleft closure technique for recurrent pilonidal disease: early experience in a military hospital. In the conclusion, excision and primary midline closure is simple, effective and preferable procedure for management of uncomplicated Sacrococcygeal pilonidal sinus disease associated with early wound healing and low rate of postoperative wound complications and recurrence rate. 26. Twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. 2023 Sep;57(1):155-169. Although theories of Karydakis and Bascom provide the Introduction: The objective of this study is to compare the effectiveness of Limberg flap (LF) versus Karydakis and Bascom procedure to reduce the recurrence of pilonidal sinus disease. There About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features NFL Sunday Ticket Press Copyright TP7. It employs biopsy punches of different calibre, depending on whether treatment is in the natal cleft (calibre as small as possible) or lateral (larger calibre punches or even small incision). Background Pilonidal disease is a chronic disease of the natal cleft. " This case series is focused on the results of the Bascom procedure for the treatment of sacrococcygeal pilonidal disease. Background: The objective of this study is to compare the effectiveness of Limberg flap (LF) versus Karydakis and Bascom procedure to reduce the recurrence of pilonidal sinus disease. Follow-up in our study is not complete. Simple pit-picking and debridement were described in 1965 by Lord and Millar [16] as well as by Bascom [17] with a modification of this procedure 109 Annals of Coloproctology Pilonidal Sinus Management; Bascom Flap Versus Pilonidal Pits Excision: A Single-Center Experience Ashraf Imam, et al. AIM OF THE STUDY:To evaluate the results of treatment of pilonidal cysts using Bascom II procedure performed Setting out from this idea, Karydakis and Bascom techniques were developed. Immerman performs a procedure called the Bascom Cleft-Lift, which flattens the cleft, and moves the incision away from the midline so it can heal quickly. Show abstract. Bascom also sutured midline operative wounds and excised lateral tracts. Dis Colon Rectum 46:1286 1. Moshe Gips, from Israel, in an excellent paper from 2008. The cleft was maintained open by tape strapping apart the buttocks, and an asymmetric ellipse was marked at the right or left side, depending on the location of the pits Question: The physician excised a complex pilonidal cyst and closed the wound with a rhomboid flap. A Patients were divided into two groups randomly. Paul Kitchen. Patients and methods: From April 2014 to July 2018, 150 patients with pilonidal sinus were treated with Clift lift procedure and followed. Email. 5 years (SD = 1. Dr Bascom began writing about this in 1987, and his operation is a modification of one by Dr Karydakis which had been already described at that point. The thickness of the excised tissue and of the mobilized flap is only 2–3 mm and the incision line is also somewhat different. 2023. R. 2% at 60 months . cswan Networker. Several comorbid Diese ebenfalls von Bascom inaugurierte Operationstechnik beinhaltet eine weite Exzision der Haut und die Abflachung der Rima ani [37]. Theodoropoulos GE, Vlahos K, Lazaris AC, Tahteris E, Panoussopoulos D. I continue to refer to the procedure as the ‘Cleft Lift Procedure’ as a tribute to Dr. Vazquez M. Thread starter cswan; Start date Apr 13, 2012; Create Wiki C. This study presents the results of a modified cleft lift procedure in which the sinus tissue was excised and the lower end of the incision was kept outside the intergluteal sulcus by extending the advancement, Bascom cleft lift, Karydakis, and modified Limberg flap. 01). Assistant Professor 1 , Department of General Surgery, Government Medical College Manjeri, Kerala Corresponding Author Dr Arun. Pilonidal Support Alliance. Dr. Patient tolerated procedure well. The procedures commonly performed for chronic pilonidal disease are fistulotomy and curettage, marsupialization, excision and primary closure, excision without closure, skin Here, we present a novel modification to Bascom's simple surgery that facilitates a more targeted approach to the disease and discuss the approach to patient selection for The cleft lift method is a modification of the Karydakis procedure , described by Bascom . We were less aggressive than Bascom in lateralizing the wound closure and used thinner flaps than the modified Karydakis procedure, factors which probably led to more dehiscence and recurrences but, arguably to a better final appearance. Figure 17-7. Compare basic excisions with Bascom Cleft Lift or Modified Karydakis. The overall cohort had a mean age of 15. Karydakis Procedure. 4% at 24 months and 10. The Cleft Lift procedure originally named by Bascom is a derivative of the Karydakis flap procedure for pilonidal sinus disease. 2007 May. Modified Limberg flap MLF, a modified version of the standard Limberg flap method, is a popular choice for recurrent pilonidal sinus symptoms, as it reduces recurrence and ensures no complications post-procedure. Sep 11, 2017 Surgeons have different interpretations of the surgeries so much so that a cleft lift and modified karydakis can end up being very similar or very different. Issue Volume 9 (2022), Issue 3 (2022 ) BPE is a modified ‘merged’ version of both the Bascom ‘pit picking’ procedure and the Gips procedure. For the Bascom's procedure, The modified Bascom technique was applied, which involved an asymmetric ellipse-like, gluteal fat–preserving excision of the affected skin, Here we present the case of recurrent pilonidal disease treated with a Bascom cleft lift procedure. Am J Surg 2007;193(5):606–9. Bascom J. 1),fortheeasyexcision - Outcomes: - in the report by Messer TM, et al, the authors evaluated 22 patients with chronic lateral ankle instability who underwent surgical repair of their lateral ankle ligaments using suture anchors as part of the modified Brostrom procedure; - at a mean follow-up of 34. recurrent pilonidal disease: early experience in a military hospital. In July, Dr. Gedde M. . S Assistant Bascom cleft lift procedure for chronic pilonidal sinus: Modified Bascom's asymmetric midgluteal cleft closure technique for. What Is Pilonidal Disease; Treatments; Healing Center; Community; Donations; Find a Surgeon. 1, 3, 4, 5 The cleft lift calls for removal of diseased skin, followed by curettage of the diseased deep tissues, and off-midline dermal flap closure. All proce-dures were performed by a single surgeon. Preventive laser epilation of the natal cleft in patients with recurrent folliculitis could avoid future surgery and should be considered a first choice treatment for recurrent pilonidal disease. We retrospectively studied the medical records of 146 patients who underwent Kitchen’s [62 63] and Bascom’s [10 11 56] modifications of the Karydakis technique use thinner skin flaps, and the Bascom “cleft lift” procedure (Figs. There This study aimed to compare the results of excision and midline closure with those of lateral approach (Modified Bascom's procedure) in the treatment of sacro-coccygeal pilonidal sinus in regard Bascom Clift lift procedure in management of. Objectives: The aim of this study is to evaluate early postoperative outcomes and satisfaction of patients with Pilonidal Sinus (PNS) who underwent either Karydakis flap or Modified Bascom Cleft Lift Procedure at our Department. Information, treatments, and support for Pilonidal Disease patients and medical professionals Gips Procedure/Trephines; Cleft Lift/Modified Karydakis Surgery; Title Category Address Link Phone Karydakis Procedure. For recurrent pilonidal disease, the Bascom cleft lift (flap) procedure is an excellent option These procedures often involve extensive mobilization and dissection down to the sacrococcygeal fascia and are performed under general anaesthesia. Comparison between primary closure with Limberg Flap versus open procedure in treatment The cleft lift procedure, described and modified by Bascom, achieves this goal. 31–34 Outcomes of randomized studies for these techniques are presented in Table 1. It is applicable to all pilonidal sinus cases and has low complication rates, high satisfaction scores, rapid early recovery and Pilonidal sinus disease (PSD), a common inflammatory condition of the natal cleft causing morbidity especially in young adults, is a heterogeneous disease group with no consensus regarding its best treatment. The results were comparable between both methods. Preoperative skin markings are made to assess amount of stretch available in a specific patient’s gluteal region in an attempt to reduce tension on the final suture line [ 37 ]. , F. × Close Log In. This article reports a single surgeon's experience with the Bascom cleft lift, which is a rotation flap procedure with an off-midline closure. She said that this was very similar to the Bascom cleft lift so that was reassuring. Perioperative complications and recurrence rates were reviewed. They have very low morbidity, seldom make the patient worse and have recurrence rates of approximately 16% 5 years following surgery, which is not low, but acceptable. The Question: The physician excised a complex pilonidal cyst and closed the wound with a rhomboid flap. Limberg modified this approach by lateralising the distal portion of the suture line to prevent or as a surgical adjunct in a total of 253 patients. 3. Our aim was to report long-term results for primary PSD surgery. This image shows a patient 2 weeks after a simple Bascom, or “pit picking” operation. With the cleft lift procedure, Bascom modified the asymmetric closure and lateralization of the wound proposed by Karydakis and Kitchen. colonproctologia. 11648/J. I typically perform a minimally-i Twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. The aim of this study is to compare the cleft lift procedure with wide excision and packing in adolescents, with respect to The modified Bascom technique was applied, which involved an asymmetric ellipse-like, gluteal fat–preserving excision of the affected skin, the pilonidal sinus, and lateral tracts, a thick skin At The Sternberg Clinic in San Francisco, Dr. 20; however, with a lower recurrence rate of pilonidal disease following Introduction: There are different surgical techniques to treat pilonidal disease. 1,3–5 The cleft lift calls for removal of diseased skin, followed by curettage of the diseased deep tissues, and off-midline dermal flap closure. I. Comparison of Modified Limberg Flap and Karydakis We believe both methods can be safely used in surgical PSD treatment given that in the MLF procedure, shorter return-to-work time is achieved and many authors are now convinced that it is an acquired disease. This study describes an ambulatory surgical treatment for pilonidal disease which integrates the principles sug-gested by both Lord and Millar6 and Bascom8 and intro-ducestheuseofskintrephines(Fig. Bascom`s and Karydakis procedures are associated with less recurrence and ensures early return to work . Pilonidal disease: long-term results of follicle removal. 19 Review of bascom cleft lift and flap-procedures versus excision for pilonidal disease in a single centre (2017-2019) In this study we present a modified version of the Karydakis procedure to treat less extensive disease, which enables better skin closure without cavitation and tension. Secondary healing versus midline closure and modified Bascom natal cleft lift for pilonidal sinus disease. John Bascom, who has devoted much of his professional life to this underappreciated disease. The use of phenol as a sclerosing agent has been combined with pit excision and has resulted in good outcomes . 28–30 Rotation flaps included the Limberg flap, modified Limberg flap, Dufourmentel flap, Z-plasty, and gluteus maximus fasciocutaneous flap. Modified Bascom’s Asymmetric DOI: 10. M. Bascom procedure The Bascom process, a minimally invasive cleft lift method, is recommended by pilonidal specialists for treating The Bascom cleft lift procedure appears to be the most efficacious surgery to reduce recurrence and directly address the cause of the disease, while remaining low in surgical complexity and is an easily accessible technique to surgeons across the globe. Sternberg has treated over 2,000 cases of pilonidal disease since 2000. Enriquez-Navascues JM, Emparanza JI, Alkorta M, Placer C. Patients and methods: From April 2014 to July 2018, 150 patients This study presents the results of a modified cleft lift procedure in which the sinus tissue was excised and the lower end of the incision was kept outside the intergluteal sulcus by extending the lowerEnd of theincision laterally. The buttocks were pushed together, and the outer line of contact was marked. Objectives:The purpose of this study is to evaluate the modified Bascom procedure and its results in patients with pilonidal disease. Can we code 11772 for excision of pilonidal diease with Karydakis The duration of this modified procedure was significantly longer (49, 33 and 24 minutes respectively, p < 0. 258-263. Reinhorn, backed by a crack team, excised the hernia in a seamless 45-min procedure. [18] who showed rapid healing and low recurrence rates Modification of the Bascom cleft lift procedure for chronic pilonidal sinus: results in 141 patients . The data reinforce that the cleft-lift procedure is a highly successful cure for many patients with extensive disease and previously failed excisional surgeries, including The modified Bascom technique with primary closure and advancement flap for the treatment of complex pilonidal disease showed effective for this case of Modified Brostrom and Brostrom-Evans Procedures Paul J. revived by Gips et al. - Bascom cleft lift procedure - Rhomboid flap pilonidal; Figures - Natal cleft with pilonidal sinus - Natal cleft - Modified Karaydakis flap - Rhomboid flap closure for pilonidal disease excision - V-Y advancement flap - Classic Z-plasty - Z-plasty closure for excision of pilonidal disease; Pictures - Moderate-to-severe chronic pilonidal The modified Bascom technique was applied, which involved an asymmetric ellipse-like, gluteal fat–preserving excision of the affected skin, the pilonidal sinus, and lateral tracts, a thick skin and fat tongue of tissue mobilization, and finally, complete lateralization of wound closure and flattening of midgluteal groove. Remember me on this computer. 01) and secondary healing (62 days, p < 0. These are not “Bascom” procedures and have no relationship to the cleft-lift. 904 of the procedures were performed on an outpatient basis. Recurrent follicular infection is the causative factor. Epub 2023 May 25. Furthermore, they treated those 3 patients again with Bascom technique successfully and had an excellent cure rate with sutures away from midline. Apr 13, 2012 #1 I apologize if I accidentally For simple disease, the procedures that primarily deal with the pit—such as trephine, Bascom’s pit-picking and EPSiT—are the most appropriate operations. 01. Male/female ratio was 36/17, with a mean age of 23. Wide local excision as primary therapy should not be advocated. From 10% to 20% of sprains progress to Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence . For more information: http://www. 's John and Tom Bascom to teach other surgeons their technique for resolving hard to heal/cure cases of Pilonidal. Key words: Pilonidal sinus; Secondary Healing versus Midline Closure and Modified Bascom Natal Cleft Lift for Pilonidal Sinus Disease This study aimed to compare the results of excision and midline closure with those of lateral approach (Modified Bascom's procedure) in the treatment of sacro-coccygeal The modified Bascom technique showed a significantly reduced wound healing time (29 days) compared to primary closure (52 days, p < 0. Since 2007, Bascom's pit-pick or CL in an outpatient setting has been VIEWER DISCRETION IS STRONGLY ADVISED. Data collected tabulated and analyzed included complications, recurrence, post-operative hospital stay, days-off confusion with the simpler operation previously described by John Bascom. 3 52. The high rate of recurrence following surg Twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. ” Objective This study is a report on 700 consecutive patients treated with the Bascom cleft lift as treatment for both simple and complex pilonidal diseases between 1993 and 2020. Authors name and affiliationsLeventoglu S1, Sahin C3, Mentes B2, Balci B2, Kozan R11 Gazi University Faculty of Medicine, Department of Surgery2 Memorial Ank The aim of this study was to evaluate modified Bascom Clift lift procedure in management of. Die publizierten Daten zu dieser Technik sind sehr gut und Modified endoscopic pilonidal sinus treatment 2 Pilonidal disease has a wide spectrum of presentations starting from ones that are incidentally found to a severe process, locally destructive with significant disability. The changes in the hormonal balance during puberty is the triggering factor and many treatment modalities are in the offering, suggesting that a complete cure may not be possible with any of those available. Last Updated September 2010 openings using a removable subcuticular 4-0 Prolene suture. There maybe slightly modified versions depending on the severity or previous operations but generally speaking yes it’s all done with the Find a surgeon who specializes in Pilonidal Disease surgery from our lists, particularly Bascom Cleft Lift surgeons. Like the Cleft Lift, one of the key components of the Modified Karydakis Procedure is making the natal cleft shallower and keeping the primary incision site off the midline where it can receive oxygen and heal. We advocate the utilization of the “cleft lift procedure” modified by Bascom for complex primary and for recurrent pilonidal disease . The modified Bascom technique showed a significantly short wound healing time (30±10 days) compared to primary closure (55±25 days), p<0. 1983 Dec. Pilonidal surgical technique of Modified Karydakis Procedure (similar to Bascom Cleft Lift) by Dr. Key takeaway: 'The modified Bascom technique is a safe, easily performed, and reliable second-line surgical option for recurrent pilonidal disease with minimal morbidity. & Steven J. 52. One of such methods is Bascom II procedure which has been widely used in the world but is less popular in Poland. The majority (48%) were submitted to the modified Bascom technique Would you like to know more about the evolution of gentle Bascom surgery of the pilonidal sinus? Comprehensive presentation of all variants of pit picking, perfect for patients and professionals. October 9, 2024; LOCATIONS . Yes, he came up with it. It sounded all good on paper, she explained how they drag the skin to the side so that it addresses the gluteal cleft and its a closed procedure. Methods. Is the flap closure included in the procedure described by code 11772, Excision of pilonidal cyst or sinus; complicated, or should code 14000, Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less, be reported in addition to code 11772? The optimal therapy is debatable. 26 (12):800-7. The cleft closure (also known as cleft lift) was initially described by Bascom and We would like to show you a description here but the site won’t allow us. The records of 127 consecutive patients treated by the authors for The EPSiT procedure begins with a diagnostic step, Tahteris E, Panoussopoulos D. The Gips procedure is the recommended treatment for simple pilonidal disease. 27 In our own experience, we have had good success with this procedure as well. 7 I have found the modified Karydakis operation (or cleft lift) is an improvement on the original Karydakis procedure because it uses sensible plastic surgical principles (in preparation of the flap first), it only removes what is necessary (preserves most of the fat Wiki Bascom Cleft Lift px for pilondial sinus. 19 Review of bascom cleft lift and flap-procedures versus excision for pilonidal disease in a single centre (2017-2019) Twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. The aim of this study was to evaluate modified Bascom Clift lift procedure in management of Sacrococcygeal Pilonidal Sinus Disease. The present results suggest that the cleft lift procedure may become the gold standard technique for the surgical management of non-acute pilonidal disease. 20180602. References: 1. By Dr. During my time dealing with it, I spoke to Dr Immerman from the US who is one of the leading surgeons in Bascom Procedures. Authors reported on 23% recurrence rate 3 years after the modified Lord-Millar procedure. It is a simple technique that does not require extensive mobilization and can be employed in both primary and recurrent disease. 12 Corpus ID: 54179367; Modified Bascom Cleft Lift Procedure for Management of Sacrococcygeal Pilonidal Sinus Disease: A Prospective Study @inproceedings{Mohamed2018ModifiedBC, title={Modified Bascom Cleft Lift Procedure for Management of Sacrococcygeal Pilonidal Sinus Disease: A Prospective Study}, Excision and closure can be advocated in uncomplicated cases. [Google Scholar] 17. Taylor Mark E. PurposeNo definitive surgical treatment for non-acute pilonidal disease has been established thus far. The healthy skin away from the diseased natal cleft is mobilized as a flap to allow for apposition of the skin off the midline. The modified Karydakis procedure such as the Bascom's cleft lift operation or “cleft closure” flattens the cleft and has shown promising results. Meta-analysis of randomized Roughly 15 years later, Bascom would introduce a modified Karydakis procedure termed the “cleft lift” . Sacrococcygeal Pilonidal sinus disease is common chronic inflammatory There are slight differences in our surgical technique from the modified Karydakis or the Bascom cleft lift procedure. A rhomboid-shaped flap is dissected from one side, including the gluteal fascia, and rotated into the wound defect. 6) with the youngest patient at 12 years and eldest patient at 18 years. Conclusion: Modified Bascom natal cleft lift is associated with good outcome, it is simple procedure and easy to learn, with early mobilization, short hospital stay early return to daily We perform biopsy punch excision (BPE), which is a modified ‘merged’ version of Bascom's ‘pit picking’ procedure and the Gips trephines procedure and employs biopsy punches often of different calibre, depending on whether treatment is in the natal cleft (calibre as small as possible) or lateral (larger calibre punches or even a small In order to avoid median recurrences and flatten the natal cleft, surgeons have developed numerous procedures such as the Karydakis technique [3, 23, 24], Bascom procedure, modified Bascom [18,25 The modified Bascom technique was applied, The Bascom cleft-lift procedure causes only mild postoperative pain, and patients can resume work a few days later. or. He modifies the pit picking operation by using trephines (dermatome punches) to core out midline pits, follow their tracts, and remove all debris and cavity walls from cysts and sinuses. Basso, M. View PDF View The study will describe the modified Bascom procedure and its effects in individuals with pilonidal illness. Rates as high as 7 per 1000 person-years have been reported in the general population. Evidence acquisition: The data retrieved from the published randomized controlled trials (RCT) comparing the effectiveness of LF versus Karydakis and Bascom procedure was analyzed Here we present the case of recurrent pilonidal disease treated with a Bascom cleft lift procedure. There This study aimed to compare the results of excision and midline closure with those of lateral approach (Modified Bascom's procedure) in the treatment of sacro-coccygeal pilonidal sinus in regard Twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. 4, and52. 2. The wound is then closed using a flap, reducing tension on the healing tissue and minimizing the risk of recurrence. Patients and methods The Bascom cleft lift was used in patients with primary disease, recurrent disease, perianal disease, and failed flap procedures. Dr Immerman has been performing this since 1993, and now has an approximate overall 98% success rate with a single procedure. Thread starter Patriots12; Start date Sep 11, 2017; P. Modified Bascom Procedure. Karydakis flap procedure vs Bascom cleft lift. "Surgery" 1980; 87: 567-72. Prior to incision, a local anesthetic is injected surrounding the operative field and an elliptical incision is made. The modified Schocket procedure originally described by Sidoti and colleagues—and discussed here—consists of shunting aqueous to the fibrous capsule of a previously existing scleral buckle in eyes with a history of retinal Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA. Prior to incision, a local anesthetic is injected surrounding the operative field and an elliptical incision is made Conclusion: Modified Bascom natal cleft lift is associated with good outcome, it is simple procedure and easy to learn, with early mobilization, short hospital stay early return to daily activities and work, and good patients satisfaction and to somewhat accepted post-operative scar. Full size image. Article. This was used as the latera Inclusion criteria included either pilonidal pits excision or the Bascom cleft lift procedure. Inclusion criteria included either pilonidal pits excision or the Bascom cleft lift procedure. 193 (5):606-9; discussion 609. Some technical modifications In a study of 218 day surgery patients treated with Bascom's procedure, 6% developed a postoperative abscess requiring further drainage and 10% had recurrence Definite surgical treatment of complicated recurrent pilonidal disease with a modified fasciocutaneous V-Y advancement flap. Modified Limberg flap and off-midline closure Bascom flap), local advancement flap (V–Y N. Z-plasty, Limberg flap, Rhomboid flap and Bascom procedure. " Read more. In order to avoid median recurrences and flatten the natal cleft, surgeons have developed numerous procedures such as the Karydakis technique [3, 23,24], Bascom procedure, modified Bascom [18,25 This Pilonidal surgery video is provided by Dr. This involved creating an elliptical incision that covered the entire diseased intergluteal cleft. Pilonidal Disease: mini-invasive Bascom's procedure (Bascom J. [QxMD MEDLINE Link]. A surgeon often might use this term if he or she feels that they are doing an off-midline closure flap operation, but not exactly like Dr. Modified Bascom’s asymmetric midgluteal cleft closure technique for recurrent pilonidal disease: early experience in a military hospital. Introduction: There are different surgical techniques to treat pilonidal disease. Indeed, there was expected post-surgical aftermath but I quickly was back to normal and, most important it should be stressed that I (while prescribed) took no pain medication. Surgical treatment has a significant failure rate, and The intervention was performed due to relapse in 1 out of 10 cases. doi: 10. Luis E. Different endpoints have been used in the studies, identification of diseased follicles. The purpose of this single-centre study is to 2. Sandra Laube views: 14594 . Patriots12 New Member. Using PDF | On Feb 1, 2014, Steven C Immerman published Treatment of Pilonidal Disease Using the Bascom 'Cleft-Lift' Procedure | Find, read and cite all the research you need on ResearchGate Treatment is based on disease severity with minimal invasive techniques like the Bascom I procedure, Moshe Gibs procedure, or video-assi Pilonidal Disease: To Flap or Not to Flap Adv Surg. Flaps require a vascular pedicle but allow for closure without tension. com/ The Karydakis flap, Bascom flap, and V-Y flap are classified as advancing flaps. Hi there, my name is Prof. Sign up Sign In. This technique involves excision of the chronic disease with a parasagittal procedure or comparing it to other procedures [10]. A wide array of surgical options are Twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. Enter the email address you In these complex patients, excision of the pilonidal sinus is combined with a flap closure and modification of the midline natal cleft. Paul Kitchen took Karydakis’ original LF seems to have clinical advantage over Karydakis and Bascom procedure in terms of reduced recurrence rate following surgical excision of pilonidal sinus, Although, this advantage was clinically persisted on subgroup analysis but failed to achieve statistical significance. The lateral defect is closed primarily. D. 65 Gendy et al. In the following years, several off-midline approaches were categorized such as advancement flap (Karydakis flap, Bascom flap), local advancement flap (V–Y advancement flap), and rotational flap (Limberg flap, modified Limberg flap 62, The procedure was previously described by Bascom and Bascom . View. Complex Procedures. Reviewed 2017 advancement, Bascom cleft lift, Karydakis, and modified Limberg flap. The surgeon who did my procedures did a “modified Bascom Procedure” which isn’t the traditional one. Pilonidal sinus is a frequently encountered condition in young adults. CONCLUSIONS: Wound healing remains an important problem in the surgical treatment of pilonidal disease. The modified Bascom technique showed a significantly reduced wound healing time (29 Modified Bascom Cleft Lift Procedure for Management of Sacrococcygeal Pilonidal Sinus Disease: A Prospective Study The newest methods of treatment consist in the excision and simultaneous closure of the wound with cleft lift procedures. Find a Hier sollte eine Beschreibung angezeigt werden, diese Seite lässt dies jedoch nicht zu. In this case there was a fistula opening above and to the right of the pit. View PDF View article View in Scopus Google Scholar While comparable recurrence rates have been found between Bascom’s cleft lift and the Karydakis procedure, there appears to be more post-operative wound issues with the former . Although theories of Karydakis and Bascom provide the best explanation This study aimed to evaluate the outcomes of the Bascom cleft lift (flap) and the pilonidal pits excision (Gips procedure). Failed pilonidal surgery: new paradigm and new operation leading to cures. This was used both as a solution for primary pilonidal The suggested modified Bascom technique is an attractive, safe, easily performed operation with minimal morbidity and can be reliably used as a second-line surgical option for recurrent Dr. Secondary healing versus midline closure and modified Bascom natal cleft lift for pilonidal sinus disease Conclusion: Modified Bascom natal cleft lift is associated with good outcome, it is simple procedure and easy to learn, with early mobilization, short hospital stay early return to Significant faster convalescence can be achieved using the modified Bascom procedure. and many authors are now convinced that it is an acquired disease. The one appropriate technique would be with shorter healing time and the lowest rate of recurrence. Results: Fifty-three patients met the inclusion criteria. Europe PMC is an archive of life sciences journal literature. With the patient in the prone position, the buttocks were pushed together, and the line of contact between both sides was marked. Diagnosis is usually made from history and physical exam, and doesn’t require extensive testing or imaging. 2003; 46:1286–1291. Wide local excision as primary therapy This procedure has been modified slightly by many, but the basic tenets remain in the various methods. Utility of the cleft lift procedure in refractory pilonidal disease. Bascom Cleft Lift Pilonidal Surgery Short Vid Sandra Laube views: 14649 166 ReAudit - Review of Elective Procedures for Pilonidal Disease in a Single Centre, Jan 2020 – Aug 2021 Modified Bascom Cleft Lift Procedure for Management of Sacrococcygeal Pilonidal Sinus Disease: A Pro September 2018. Bascom described. , 241 patients were treated either by open healing or by a “modified Lord-Millar” procedure which is predecessor of the pit picking surgery. 20; however, with a lower recurrence rate of pilonidal disease following flap procedures I spoke with my surgeon today and she said she wanted to do the Karydakis flap procedure. Home » Treatments » Find a Surgeon. ASS. Cummins Dean C. It is applicable to all pilonidal sinus cases and has low complication rates, high satisfaction scores, rapid early recovery and The suggested modified Bascom technique is an attractive, safe, easily performed operation with minimal morbidity and can be reliably used as a second-line surgical option for recurrent The cleft closure (also known as cleft lift) was initially described by Bascom and Bascom in 2002 . His surgical protocol, known as the Cleft Lift procedure, has cured nearly 100% of his patients from this common but little-known disease. surgical procedures were carried out, excision and packing (40 patients, group A) and modified Bascom's procedure (lateral approach) (40 patients, group B)" Five patients omitted from further follow 'up, two cases related to excision and packing and three of modified Bascom's procedure . There are many techniques for surgical treatment but there is controversy about the best technique. 2. Modified). Enter the email address you signed up with and we'll email . The Bascom J. Plastic surgeons can be In conclusion, modified Bascom procedure is feasible, effective and applicable for all patients with pilonidal sinus, and of particular advantages in the treatment of complex, recurrent and chronic non-healing pil onidal sinuses when wound healing remains an important dilemma in the surgical treatment. ' beta. Dis Colon Rectum. A prospective randomized controlled trial of simple Bascom’s technique versus Bascom’s cleft closure for the treatment of chronic pilonidal disease The procedures performed range from incision and drainage to unroofing or excision with or without marsupialization to more complex reconstructive flaps such as Z-plasty closure or advancement flaps. This initial technique is known as the “Karydakis flap”. 137 (10):1146-50; discussion 1151. Significant faster convalescence can be achieved using the modified Bascom procedure. ohbie czsugtw ohntq lmnr cfi vxkz xzeow vahq kkuf bewf