Closed Technique with Suction Drain versus Partial Closure Technique in Midline Repair of Pilonidal Sinus: A Comparative Study

ABSTRACT Background:Controversy still exists about the exact cause of pilonidal sinus either acquired or congenital, and also about what is the best surgical technique for the treatment of the disease. We successfully treated chronic pilonidal sinus with a new flap technique {N-shaped bilateral rotation flap} for closure of the defect.Materials and Methods:Thirty-two patients (30 men and two women) were treated by eccentric elliptical excision of the diseased tissues down to the postsacral fascia and closure of the defect with our flap [which is a random pattern flap], then a closed suction drain was placed at the base of the wound, with its tip being brought out in the gluteal region at least 5 cm lateral to the lower end of the suture line. Results: All our patients healed completely without recurrence during a period of average follow-up of two years. Mean hospital stay was 1.5 days (range 1-5 days). Mean time to complete healing was 11.9 days (range 6-18 days). Mean time off work was 13.7 days (range 10-21 days). Two patients had wound infection and one patient a partial breakdown. The recurrence rate was 0%.Conclusions:A tension-free suture via bilateral rotation flaps with a good suction at the button of the wound for drainage of blood from the bottom of the wound is the key to the success of repair without recurrence.

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Local Phenol Application Versus Excision with Modified Primary Closure Technique in Pilonidal Sinus Disease: A Comparative Study

Advances in Surgical Sciences ◽

10.11648/j.ass.20180601.14 ◽

2018 ◽

Vol 6 (1) ◽

pp. 20

Author(s):

Adel Morad Abdallah

Keyword(s):

Comparative Study ◽

Pilonidal Sinus ◽

Primary Closure ◽

Pilonidal Sinus Disease ◽

Closure Technique ◽

Sinus Disease

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Limberg Flap is a Safe and Effective Procedure for the Surgical Treatment of Pilonidal Sinus in Sacrococcygeal Region

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v12i1.51611 ◽

2021 ◽

Vol 12 (1) ◽

pp. 6-8

Author(s):

Md Rashidul Islam ◽

Abul Bashar Md Abdul Matin ◽

Sami Ahmad ◽

Md Armanul Islam ◽

Shoaeb Imtiaz Alam

Keyword(s):

Postoperative Pain ◽

Pilonidal Sinus ◽

Young Male ◽

Main Concern ◽

Limberg Flap ◽

Suction Drain ◽

Sacrococcygeal Region ◽

Flap Procedure ◽

Secondary Closure

Pilonidal sinus in the sacrococcygeal region is an acquired condition and usually seen in young male adults. Diagnosis is indicated by to see the site and appearance of chronic discharging opening, and identification of midline pit in the natal cleft. The management of the sacrococcygeal pilonidal sinus varies from clipping of hairs with good hygiene of the area, wide excision of the area with primary or secondary closure and newer flap procedures, but none is widely accepted. The main concern for the treatment to the patient is the recurrence. This prospective study has been performed to determine the effectiveness and safety of the Limberg flap procedure for sacrococcygeal pilonidal sinus for new and recurrent cases. Primary end point was rate of recurrence and secondary end points were its complianceand complications such as wound infection, postoperative pain and return to work. A total of 17 patients were operated from March 2012 to June 2016.Both primary and recurrent diseases were included. All patients successfully underwent surgery. Patients complained very minimal postoperative pain. LO were average 2 days. All patients were discharged with negative suction drain in situ. Drains were removed on 7th POD and stitches were removed on 9th to 12th postoperative day. All patients returned to work after 2nd weeks. In our study no recurrence or major complications were found. Limberg flap for sacrococcygeal pilonidal sinus was found very useful and effective in terms of recurrence rate and patients morbidity. J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 6-8

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