Comparison of Limberg Flap and Modified Limberg Flap in Pilonidal Sinus Surgery in Adolescents

Introduction: Pilonidal sinus is an inflammatory disease seen mostly in the intergluteal region of young males. Although any treatment strategy of this condition is generally free of life-threatening complications due to its superficial nature, it is still a feared disease because of recurrence which greatly increases the morbidity. Objective: To investigate the results of wide rhomboid excision and modified Limberg transposition flap reconstruction to treat recurrent pilonidal sinus. Methodology: Well-documented records of all patients with recurrent sacrococcygeal pilonidal sinus who underwent wide excision and a modified Limberg transposition flap at our center during the past 3 years and followed up for longer than 12 months were analyzed. The modification primarily consisted of an asymmetrically rotated rhomboid excision and lateralization of the lower midline. Patient demographics, days of hospitalization, complications, patient satisfaction and recurrence rates were evaluated. Result: Most patients in the study were overweight. No relationship was detected between BMI and number of sinus openings, hospital stay, drain placement or recurrences but an association with infection was noted. The number of pilonidal sinus orifices did not have a correlation with age, number of previous surgeries, duration of hospital stay or drains placement. The mean duration of hospitalization was 7.89 ± 3.41 days and the mean duration of suction drainage was 6.33±2.87 days. Half of our patients developed complications in the postoperative period. The only patient who developed superficial wound infection stayed the most in the hospital. All patients had some complaints regarding the operation site; however, they were satisfied with the result of the operation and had no recurrence at 12 months of follow-up. Conclusion: Rhomboid excision of recurrent sacrococcygeal pilonidal sinus with modified Limberg flap closure is a promising surgical technique with advantages of a good patient satisfaction and no recurrence after a year of surgery.

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The short-term results of modified limberg flap in treatment of pilonidal sinus disease

Zagazig University Medical Journal ◽

10.21608/zumj.2021.52827.2040 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Khalid Elsayed ◽

Ibrahim Heggy ◽

Abdelrahman Sarhan

Keyword(s):

Pilonidal Sinus ◽

Pilonidal Sinus Disease ◽

Limberg Flap ◽

Short Term ◽

Sinus Disease ◽

Modified Limberg Flap

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Comparison of Modified Limberg Flap and Karydakis Flap Operations in Pilonidal Sinus Surgery: Prospective Randomized Study

International Surgery ◽

10.9738/intsurg-d-14-00213.1 ◽

2015 ◽

Vol 100 (5) ◽

pp. 870-877 ◽

Cited By ~ 25

Author(s):

Mehmet Tokac ◽

Ersin Gurkan Dumlu ◽

Murat Seyit Aydin ◽

Abdussamed Yalcın ◽

Mehmet Kilic

Keyword(s):

Return To Work ◽

Pilonidal Sinus ◽

Randomized Study ◽

Sitting Time ◽

Long Term Results ◽

Limberg Flap ◽

Significant Difference ◽

Modified Limberg Flap ◽

Short And Long Term

The best surgical technique for pilonidal sinus disease (PSD) is still disputed. The objective of this prospective randomized study is to compare the short and long-term results of modified Limberg flap and Karydakis flap surgeries that have been widely used in recent years. Ninety one patients were included in the study. The patients were divided into two groups: modified Limberg flap (MLF; n = 46) and Karydakis flap (KF; n = 45). Preoperative findings of the patients, their surgical findings, and short and long-term postoperative findings were recorded and statistically compared. While no significant difference was discovered between the groups in terms of postoperative analgesic need, hospital stay, postoperative infection rate, drain stay time, painless sitting time, painless toilet-sitting time, and painless walking time, return to work or school time was shorter in the MLF group compared with the KF group (20.61 ± 7.89 days, 23.29 ± 6.42, respectively; P < 0.05). Cosmetically, the visual analog scale (VAS) of the KF group was significantly higher than that of the MLF group (VAS score 7.12 ± 1.28, 5.45 ± 1.77, respectively; P < 0.05). Considering recurrence rates, no statistically significant difference was found between the groups. Our study found out that short and long-term results of the MLF and KF procedures are similar. 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, while the procedure provides better cosmetic results.

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