{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:25:45Z","timestamp":1786951545187,"version":"build-2736575974"},"reference-count":48,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003009","name":"Science and Technology Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003009","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Successful 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\u2010reported recovery as regards sexual function and driving ability following the KF versus the LF for primary sacrococcygeal PSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study (FLARE study) included employed, sexually active patients who underwent surgery for primary PSD (July 2017\u2013July 2024). The primary outcome was time to sexual activity resumption; the secondary outcome was time to resumption of driving. Outcomes were assessed at 1\u00a0year using a structured Likert\u2010scale questionnaire. Kaplan\u2010Meier curves and Cox regression analyses with adjustment were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 352 patients were divided into 176\u00a0KF and 176 LF. KF patients resumed sexual activity earlier (2.88\u00a0\u00b1\u00a00.7 vs. 4.58\u00a0\u00b1\u00a01.1\u00a0weeks; mean difference \u22121.7\u00a0weeks, 95% CI \u20131.89 to \u22121.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). 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 \u22121.78, 95% CI \u20132.02 to \u22121.53). KF resumed driving earlier (median 9 vs. 19\u00a0days;\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.7, large effect,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and had longer sitting tolerance (OR 0.3, 95% CI 0.2\u20130.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). LF had higher pain while sitting (mean Likert 4 vs. 2; mean difference of \u22121.94, 95% CI \u20132.19 to \u22121.68), higher VAS pain (median 4 vs. 2;\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.5), greater need for cushions\/analgesics, and more driving\u2010related work\/social limitations (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). 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\u20137.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and delayed return to driving (adjusted OR 2.8, 95% CI 1.5\u20135.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In 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\u2010centered functional outcomes into surgical decision\u2010making for PSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Number: NCT07271537.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70463","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:27:25Z","timestamp":1781764045000},"page":"2241-2256","source":"Crossref","is-referenced-by-count":0,"title":["Karydakis Versus Limberg Flap in Primary Sacrococcygeal Pilonidal Sinus: A Retrospective Comparative Study of Functional Recovery"],"prefix":"10.1002","volume":"50","author":[{"given":"Tamer A. A. M.","family":"Habeeb","sequence":"first","affiliation":[{"name":"Department of General Surgery Faculty of Medicine Zagazig University  Zagazig Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9956-0291","authenticated-orcid":false,"given":"Abdulzahra","family":"Hussain","sequence":"additional","affiliation":[{"name":"Sheffield University  Sheffield UK"},{"name":"University of Alkafeel  Kufa Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Bueno\u2010Lled\u00f3","sequence":"additional","affiliation":[{"name":"Hospital Universitari i Polit\u00e8cnic la Fe  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano Eduardo","family":"Gim\u00e9nez","sequence":"additional","affiliation":[{"name":"University of Strasbourg  Strasbourg France"},{"name":"Scientific Director of Percutaneous Surgery IHU\u2010IRCAD  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Aiolfi","sequence":"additional","affiliation":[{"name":"Division of General Surgery Department of Biomedical Science for Health I.R.C.C.S. 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