A prospective study on limberg flap procedure for pilonidal sinus

Pilonidal sinus is a blind ending track containing hair follicles within it and is primarily a disease involving sacrococcygeal region. The exact etiology of this disease process is unknown and is still controversial. There are various treatment methods for pilonidal sinus and the preferred method is Limberg flap reconstruction surgery due to its less complications and less recurrence. Our study was a prospective study including 28 patients who were admitted for pilonidal sinus and operated by Limberg flap reconstruction surgery at Veer Surendra Sai Institute of Medical Sciences And Research from January 2018 to June 2020. Our study included 28 patients, and the female to male ratio is 1:13. Duration of symptoms had a range from 1-4 months and the mean age of the study population was 28.5 year. Patients underwent Limberg flap reconstruction surgery and 89.28% followed a normal course after surgery , 7.14% developed seroma and 3.57% developed surgical site infection in their post-operative period. Limberg flap reconstruction surgery is the most preferred method of treatment for pilonidal sinus because of its low infection and recurrence rates, better aesthetic results after surgery and short duration of hospital stay.

Download Full-text

Limberg flap for pilonidal sinus: an institutional study

International Surgery Journal ◽

10.18203/2349-2902.isj20164700 ◽

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.

Download Full-text

A Prospective Study and Clinical Trial Comparing Modified Limberg Transposition Flap Reconstruction with Excision and Primary Closure in the Treatment of Uncomplicated Sacrococcygeal Pilonidal Sinus

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i3.146 ◽

2017 ◽

Vol 05 (03) ◽

pp. 19235-19241

Author(s):

Atul Kumar Vyas ◽

Keyword(s):

Clinical Trial ◽

Prospective Study ◽

Pilonidal Sinus ◽

Primary Closure ◽

Flap Reconstruction ◽

Transposition Flap ◽

A Prospective Study

Download Full-text

Limberg flap procedure for sacrococcygeal pilonidal sinus: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20172773 ◽

2017 ◽

Vol 4 (7) ◽

pp. 2238 ◽

Cited By ~ 1

Author(s):

Prashant Kumar Singh ◽

Rohit Kumar Gohil ◽

Neeraj Saxena

Keyword(s):

Pilonidal Sinus ◽

High Recurrence Rate ◽

Limberg Flap ◽

Flap Reconstruction ◽

High Patient Satisfaction ◽

Reliable Technique ◽

Average Hospital ◽

Flap Procedure ◽

Low Incidence ◽

A Prospective Study

Background: Sacrococcygeal pilonidal sinus is a common and morbid disease associated with high recurrence rate after surgery. Many conventional surgical procedures have been described for its management with their merits and demerits. The present study aims to evaluate the efficacy and complications of Limberg flap reconstruction surgery.Methods: 32 consecutive patients underwent Limberg flap reconstruction between January 2015 to November 2016 and were evaluated for various parameters.Results: All patients successfully underwent surgery, with very minimal postoperative pain, average hospital stay for 5 days, returned to work after 19 days, with 2 patients having seroma, 1 having flap necrosis, 1 developed wound infection and no recurrences so far. Patients with complications were managed conservatively.Conclusions: Limberg flap for reconstruction of the defect after excision of recurrent sacrococcygeal pilonidal sinus is an effective and reliable technique, easily performed, with high patient satisfaction, associated with complete cure and low incidence of post-operative complications.

Download Full-text

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

Journal of Dhaka Medical College ◽

10.3329/jdmc.v29i1.51169 ◽

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

Download Full-text

Modified Limberg Flap for Pilonidal Sinus

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v15i1.18050 ◽

2017 ◽

Vol 15 (1) ◽

pp. 35-38

Author(s):

Prabin Bikram Thapa ◽

DK Maharjan ◽

R Ghimire ◽

SK Shrestha

Keyword(s):

Pilonidal Sinus ◽

Hair Follicles ◽

Hair Removal ◽

Pilonidal Sinus Disease ◽

Limberg Flap ◽

Flap Reconstruction ◽

Post Surgery ◽

Duration Of Surgery ◽

Modified Limberg Flap ◽

Rhomboid Excision

Background: Pilonidal sinus disease is a common condition usually seen in young adults. Although several methods of treatment have been described, but all have been associated with high recurrence rates. This study was carried out to evaluate the advantages and results of rhomboid excision and Limberg flap reconstruction in the management of pilonidal sinus disease.Objective: To evaluate the advantages and results of rhomboid excision and Limberg flap reconstruction in the management of pilonidal sinus diseaseMaterial and Methods: This was prospective descriptive study conducted in Unit III, Department of Surgery, Kathmandu Medical College Teaching Hospital from August 2013 to August 2015. First 50 patients with diagnosis of pilonidal sinus were included .Exclusion criteria was patients with pilonidal abscess.Results: Total 50 patient were included in 2 years time. Mean age was 23.48 ± 3.9 years with all male patients only. Median duration of surgery was 32 ± 4.4 minutes .Median time for normal activities was 21± 3.9 days and median follow up time was 18±8.5 months. No recurrence was noted till then. Post surgery, patient applied hair removal cream: 44%, hair shaving: 34% and laser therapy for hair follicles: 22%.Conclusion: Modified Limberg flap is better option for pilonidal sinus with least recurrence. However, post surgical counseling for hair removal is very important in order to prevent recurrence and should be multidisciplinary approach along with dermatologist colleagues.

Download Full-text

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

Our Dermatology Online ◽

10.7241/ourd.20163.73 ◽

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

Download Full-text

Limberg Flap reconstruction for pilonidal sinus

Khirurgiya Zhurnal im N I Pirogova ◽

10.17116/hirurgia202111134 ◽

2021 ◽

pp. 34

Author(s):

M.A. Danilov ◽

G.G. Saakyan ◽

A.V. Leontyev ◽

A.B. Baichorov ◽

Z.M. Abdulatipova

Keyword(s):

Pilonidal Sinus ◽

Limberg Flap ◽

Flap Reconstruction

Download Full-text

Surgical reconstruction of pilonidal sinus disease with concomitant extracellular matrix graft placement: a case series

Journal of Wound Care ◽

10.12968/jowc.2021.30.sup7.s28 ◽

2021 ◽

Vol 30 (Sup7) ◽

pp. S28-S34

Author(s):

Abigail E Chaffin ◽

Shane G Dowling ◽

Mychajlo S Kosyk ◽

Brandon A Bosque

Keyword(s):

Extracellular Matrix ◽

Postoperative Complications ◽

Pilonidal Sinus ◽

Case Series ◽

Surgical Reconstruction ◽

Pilonidal Sinus Disease ◽

Surgical Approaches ◽

Flap Reconstruction ◽

Recurrence Rates ◽

Sinus Disease

Background: Pilonidal sinus disease (PSD) is a chronic inflammatory disease affecting the soft tissue of the sacrococcygeal region and remains a challenging disease for clinicians to treat. The optimal treatment for PSD remains controversial and recent reports describe several different surgical approaches offering different benefits. Approximately 40% of initial incision and drainage cases require subsequent surgery. Due to high recurrence rates and postoperative complications, a more complex revision surgery involving a flap reconstruction may be required. We hypothesised that the combination of an extracellular matrix (ECM) graft with tissue flap reconstruction may decrease the postoperative complications and recurrence rates for PSD. Method: We report a retrospective case series using a surgical flap reconstruction with concomitant implantation of an ovine forestomach ECM graft under a fasciocutaneous flap with an off-midline closure for recurrent PSD, where previously surgical intervention had failed due to wound dehiscence and/or recurrent disease. Results: The case series included six patients. After three weeks, all patients except one were fully healed, and the sixth was fully healed by week 4; all wounds remained fully healed at 12 weeks. All patients achieved good cosmesis and were able to return to normal function without any residual symptoms. Conclusion: This pilot case series explored augmenting a flap reconstruction for complex PSD with advanced ECM graft materials, demonstrating that it may improve outcomes and minimise typical complications seen in flap closure, such as inflammation, infection, haematoma/seroma and hypoperfusion. Although the study had a limited number of participants, long-term outcomes were promising and suggest that further studies are warranted.

Download Full-text