scholarly journals D-shape asymmetric excision with primary closure versus limberg flap surgery for sacrococcygeal pilonidal sinus

2021 ◽  
Vol 8 (10) ◽  
pp. 3064
Author(s):  
Naveen Rajendra ◽  
Venugopal Karigowda ◽  
Girish Honnavara Raju ◽  
Nitish Suresh
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Flap Reconstruction ◽  
Vas Score ◽  
Significant Difference ◽  
Group 2 ◽  
Asymmetric Excision ◽  
Group 1

Background: Treatment of sacrococcygeal pilonidal disease with off-midline closure after excision has been suggested to improve surgical outcomes. The aim of this study was to compare the short-term outcomes in patients with sacrococcygeal pilonidal disease, who underwent D shaped asymmetrical excision with flap reconstruction and Limberg flap reconstruction.Methods: An analysis of 50 patients was done; 25 were treated with D shaped asymmetrical excision with flap reconstruction and 25 with Limberg flap reconstruction procedure from September 2015 to Feb 2017 and were followed up for six months to 1 year.Results: There were significant difference between group 1 and group 2 with respect to operation time (mean: 40.20±3.19 min and 49.24±3.76 min, p<0.001), blood loss (mean: 45.64±2.93 mland 61.04±3.34 ml, p<0.001). Visual analog scale score was evaluated on postoperative day 15 and 30. On postoperative day 15, VAS score was 2.52±0.77 in group 1 and 3.12±0.97 in group 2. On day 30, VAS score was 1.56±0.77 in group 1 and 2.16±0.94 in group 2, and the differences were statistically significant. The complications were lesser I patients with D shaped asymmetric excision when compared to Limberg flap.Conclusions: The D-shape procedure is an easier and safer treatment option when compared to Limberg flap for the surgical treatment of sacrococcygeal pilonidal sinus disease owing to the associated low complication rate, short duration to return to normal activity, faster healing, and a high patient satisfaction rate and an easier learning curve.

scholarly journals Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery

2018 ◽  
Vol 119 (4) ◽  
pp. 148-155 ◽  
Author(s):  
Abdulcabbar Kartal ◽  
Hüseyin Onur Aydın ◽  
Mehmet Oduncu ◽  
Murat Ferhat Ferhatoğlu ◽  
Taner Kıvılcım ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Transposition Flap ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Our study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Limberg transposition flap (LTF) was performed in 131 patients (group 1), Karydakis flap (KF) was performed in 232 patients (group 2) and primary closure (PC) after excision was performed in 271 patients (group 3). Patient demographics, operative and postoperative outcomes were recorded and analyzed retrospectively. The mean age (p=0.98), sex ratio (p=0.74) and removed sinus volume (p=0.67) were not statistically different between groups. Mean operative time was 54.3 ± 6.4 min for group 1, 46.8 ± 10.5 min for group 2, and 26.9 ± 5.8 min for group 3 respectively (p=0.01). When the length of hospital stay was compared, there was a significant difference in favor of primary closure (p=0.01). Regarding early surgical complication, Karydakis flap technique was superior to other groups (p<0.001). The recurrent rate was higher in the primary closure group (p<0.001). In our study, the primary closure method regarding the duration of surgery and hospitalization; Karydakis method regarding postoperative complications (seroma, hematoma, wound dissociation, infection, recurrence) were superior to the other two methods.

scholarly journals The limberg flap reconstruction – the optimal surgery for pilonidal sinus disease

2016 ◽  
Vol 7 (3) ◽  
pp. 271-275
Author(s):  
Ramu Shapur Srihari ◽  
Appaji Mandya Naveen ◽  
Harinatha Sreekar
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Flap Reconstruction ◽  
Sinus Disease

scholarly journals Management of pilonidal sinus disease with Limberg flap: our experience

2020 ◽  
Vol 7 (5) ◽  
pp. 1575
Author(s):  
Mahavir Singh ◽  
Saish Dalal ◽  
Baleshwar . ◽  
Sethu Raman
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Tertiary Care ◽  
Pilonidal Sinus Disease ◽  
Common Disease ◽  
Main Concern ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Minimal Scarring ◽  
Early Return

Background: Pilonidal sinus disease is a common disease of young adults. The management of the sacrococcygeal pilonidal sinus varies from conservative measures to various surgical procedures. The main concern for the treatment to the patient is the recurrence. Although several methods have been described all have been associated with high recurrence rates. This study was carried out to evaluate the advantages, results of rhomboid excision and limberg flap reconstruction in the management of pilonidal sinus disease.Methods: This prospective study was conducted in General Surgery department of a tertiary care centre of Haryana. It includes 29 patients who were treated for pilonidal sinus disease by Limberg flap surgery from January 2015 to January 2019.  Results: All patients were successfully treated with minimal postoperative discomfort. Only two patients developed seroma which was managed conservatively and in two patients there was slight flap tip necrosis which was also managed conservatively. Rest all other patients wound healed nicely with minimal scarring, with very less postoperative pain, with no recurrence so far.Conclusions:Limberg flap is very effective treatment for pilonidal disease. It has many advantages as it is easy to perform and design, and it flattens the natal cleft with large vascularized pedicle, sutured without tension. This in turn maintains good hygiene, reducing the friction, preventing maceration, and avoiding scar in the midline. The technique is easy to perform in quick time, useful in both primary and recurrent diseases, with very low complication and recurrence rate. Other advantages are quick healing time, short hospital stay, and early return to daily life.  

scholarly journals Limberg flap for pilonidal sinus: an institutional study

2017 ◽  
Vol 4 (2) ◽  
pp. 496
Author(s):  
Sameer Ahmed Mulla ◽  
Srinivas Pai ◽  
Prakash Mahalingashetty
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Recurrence Rates ◽  
Duration Of Symptoms ◽  
Surgical Data ◽  
The Mean ◽  
Surgical Modality ◽  
A Prospective Study

Background: Pilonidal sinus disease is a common disorder affecting the gluteal cleft and it is notoriously recurrent. Limberg flap is a well-known surgical modality for the treatment of pilonidal sinus. This study aims at studying the surgery in a single institution.Methods: This is a prospective study of 17 limberg flaps done from 2013 to 2016. The various demographic, clinical and surgical data are studied and compared to other studies.Results: In this study, 17 patients of sacrococcygeal pilonidal disease underwent rhomboid excision and limberg flap reconstruction. The mean duration of symptoms was 6.52 months (2-13 months), and the mean operative time was 67.05 min with a range from 60 to 90 min. The mean post-operative stay was 6.05 days (3 to 10 days).Conclusions: Recurrence is known and hence surgery with flap coverage not only decreases the recurrence rates, but it also makes the stay short by eliminating daily dressing. Limberg flap is an easy and efficient way with less and manageable complication.

Study of laser treatment in primary pilonidal disease at a tertiary hospital

2021 ◽  
Vol 19 (1) ◽  
pp. 01-04
Author(s):  
Nitish Jhawar ◽  
Keyword(s):  
Hospital Stay ◽  
Laser Treatment ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Normal Activity ◽  
Tertiary Hospital ◽  
Pilonidal Sinus Disease ◽  
Invasive Technique ◽  
Recurrence Rates ◽  
Vas Score

Background: Pilonidal sinus is a pathology that occurs with acute or chronic infection in the natal cleft, especially in young men. In order to decrease complications and recurrence rates after pilonidal sinus excision, it is desirable to use a less invasive technique that allows patients to recover more quickly and permanently. Present study was aimed to evaluate laser Pilonidotomy, a new technique for the treatment of pilonidal sinus. Material and Methods: Present study was a prospective, observational study conducted in ppatients diagnosed as cases of pilonidal sinus disease, attending surgical OPD, underwent laser pilonidotomy. Results: Total 32 patients were evaluated. Male patients (90.63%) were far more than female patients (9.38%). Mean duration of procedure was 30.34 ± 8.24 minutes, mean duration of hospital stay was 14.65 ± 7.13 hours. Most of patients resumed normal activity in 1.96 ± 0.81 days while complete wound healing by secondary intention was noted after 4.5 ± 1.2 weeks. Successful primary treatment was done in 90.63 %. Recurrence was noted in 3 patients (9.38 %). Infection (6.25 %) was noted in 2 patients, less common complications were bleeding (3.13 %), severe postoperative pain (3.13 %), hypertrophic scar (3.13 %). VAS score analysis was done and a significant change in VAS score was noted between day 1 and day 7. Conclusion: Laser treatment in primary pilonidal disease is minimal invasive surgery, is easy to perform with major advantages such as shorter hospital stay, less post-operative pain and care and the final aesthetic aspect.

scholarly journals Limberg Flap Procedure for Managing Sacrococcygeal Pilonidal Sinus Disease: our Experience

2021 ◽  
Vol 29 (1) ◽  
pp. 38-40
Author(s):  
Nelema Jahan ◽  
Md Mamunur Rahman ◽  
Suman Chandra Roy ◽  
Suborna Islam ◽  
Mohammad Shahidul Alam ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Demographic Data ◽  
Pilonidal Sinus Disease ◽  
High Recurrence Rate ◽  
Limberg Flap ◽  
Flap Reconstruction ◽  
Medical College ◽  
Operative Complications ◽  
A Prospective Study ◽  
Post Operative Complications

Background: Sacrococcygeal pilonidal sinus is a common morbid disease in young adult patients with high recurrence rate. There are several surgical procedures for managing pilonidal sinus. The present study aims to evaluate the efficacy of limberg flap reconstruction surgery for the management of sacrococcygeal pilonidal sinus. Methods: A prospective study was conducted over a period of more than two years from January 2017 to June 2019. A total of 21 patients were included in this study. All patients underwent Limberg flap reconstruction. Data collected in data collection sheet regarding demographic data, post operative complications and analyzed in tabulated form. Results: Total 21 patients were included in our study. Age ranged from 20-50 years. Male were 18(85.71%) and female were 3(14.29%). Post operative complications were seroma 2(9.52%), wound infection 1(4.76%). But no flap necrosis and recurrence had occurred. Conclusion: Limberg flap for reconstruction of the defect after excision of sacroccoccygeal pilonidal sinus is an effective and safe technique with low complication rate. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 38-40

scholarly journals ‘D’ Excision for Sacrococcygeal Pilonidal Sinus Disease

1987 ◽  
Vol 80 (5) ◽  
pp. 292-295 ◽  
Author(s):  
C V Mann ◽  
R Springall
Keyword(s):  
Hospital Stay ◽  
Success Rate ◽  
Pilonidal Sinus ◽  
Suture Technique ◽  
Pilonidal Sinus Disease ◽  
Previous Surgery ◽  
Primary Suture ◽  
Sinus Disease ◽  
Group 2 ◽  
Group 1

A new procedure is described for treating pilonidal sinus by an excision and primary suture technique, and the results reported in 30 consecutive patients so treated - 28 with chronic sinuses and 2 with an acute abscess. Seventeen patients (Group 1) had had no previous surgery, while 13 (Group 2) had had multiple previous operations. A total of 24 patients (80%) healed after the operation, their mean hospital stay being 16 days. In Group 1 the success rate was 88% with a mean hospital stay of 15 days; in Group 2 the comparable figures were 69% and 17 days. After additional procedures (usually curettage) all patients healed.

scholarly journals Pre operative use of injection diclofenac versus injection tramadol for pain management of acute appendicitis in emergency department

2017 ◽  
Vol 13 (1) ◽  
pp. 40-48
Author(s):  
Saroj Giri ◽  
S Chaudhuri ◽  
S Jirel ◽  
BD Aryal ◽  
DR Kumar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Appendicitis ◽  
Drug Administration ◽  
Vas Score ◽  
Significant Difference ◽  
Common Causes ◽  
Diagnosis Accuracy ◽  
Group 2 ◽  
Group 1

Background: Acute appendicitis is one of the most common causes of acute abdominal pain presenting in emergency department. Preoperative use of adequate analgesia markedly reduces pain without affecting diagnosis accuracy and furthermore no single analgesia has been used for this purpose.Objective: To determine and compare the efficacy of injection diclofenac and injection tramadol for rapid pain management of acute appendicitis in emergency department.Methods: An experimental clinical trial was done including 50 patients aged _8 years who were clinically diagnosed as acute appendicitis and had not received analgesia prior to examination by the researcher. They were randomly divided into 2 groups: 25 patients (group 1) were given injection diclofenac intramuscularly and 25 patients (group 2) were given injection tramadol intravenously. Comparative analysis was carried out regarding the decrease in pain intensity using visual analogue scale (VAS) score for pain at presentation, at half an hour and at one hour of drug administration.Results: All the patients had VAS score of _5 at presentation without significant difference in the two groups. Half an hour after drug administration, 64% of subjects still had a VAS score of _6 in the first group while only 12% in the second group (p=0.005). At one hour of drug administration, 64% of subjects had a VAS score between 4 and 7 and 36% had score between 0 and 3 in group 1. In contrast to this score, in group 2 only 16% of the subjects scored between 4 and 7 and 84% between 0 and 3 (p=0.001).Conclusion: There was rapid and marked decrease of VAS score or pain in tramadol group as compared to diclofenac group. Hence, we can recommend that injection tramadol intravenous be considered for preoperative use for pain management of acute appendicitis in emergency department. Health Renaissance 2015;13 (1): 

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