Compare outcome of simple excision with primary closure vs rhomboid excision with limberg flap for pilonidal sinus

2021 ◽  
pp. 2920-2922
Author(s):  
M. Kaleem ◽  
F. Mubarik ◽  
M. U. Afzal ◽  
A. Zahid ◽  
W. I. Andrabi ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Advancement Flap ◽  
Pilonidal Sinus Disease ◽  
P Value ◽  
Limberg Flap ◽  
Simple Excision ◽  
Group A ◽  
Group B ◽  
Rhomboid Excision

Background: Sacrococcygeal pilonidal sinus is a common condition usually affecting young-to-middle-aged men. For managing sacrococcygeal pilonidal illness, a variety of lateralizing surgical flap procedures based on this principle have been published, including the Karydakis flap, Limberg flap, modified Limberg flap, Z-plasty, and Y-V advancement flap. Aim: To compare the outcome of simple excision with primary closure versus rhomboid excision with limberg flap for sacrococcygeal pilonidal sinus. Methodology: Randomized control study conducted in Surgery Department, Ghurki Trust Hospital, Lahore. 90 patients fulfilling the inclusion criteria were selected from wards and were randomly divided in two equal groups. In group A, patients underwent rhomboid excision with limberg flap. In group B, patients underwent simple excision with primary closure. The operation was performed under spinal anesthesia. After surgery, patients were evaluated every 24 hours if they are able to move on their own then they were discharged and hospital stay was noted. Then after 10 days, patients will be called in OPD for assessment of wound healing. If wound did heal and patient complained of pain (VAS>4) and cannot sit and have fever (temp>100oF) Results: The average age in group A was 44.37±15.42 years while that in group B was 45.24±14.50 years. In group A there were 23(51.1%) males and 22 (48.9%) females whereas in group B there were 25(55.6%) males and 20(44.4%) females. There was difference significant in the mean stay in hospital in both groups (p-value=0.002). Conclusion: The conclusion of the study, that primary sacrococcygeal pilonidal sinus disease and rhomboid excision with Limberg's flap is an effective treatment. Keywords: Simple Excision with Primary Closure, Rhomboid Excision, Limberg Flap, Sacrococcygeal Pilonidal Sinus

scholarly journals Comparative study between excision with primary closure versus Limberg flap for treatment of primary sacrococcygeal pilonidal sinus

2017 ◽  
Vol 4 (11) ◽  
pp. 3581 ◽  
Author(s):  
Omar Abdelraheem ◽  
Magdy Khalil
Keyword(s):  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Significant Difference ◽  
Flap Repair ◽  
Group A ◽  
Group B ◽  
Rhomboid Excision

Background: Surgical treatment of sacrococcygeal pilonidal sinus is associated with significant recurrence rate. However; recent study suggested the use of rhomboid excision and Limberg flap repair as feasible procedure for treatment of pilonidal sinus disease. Our aim is to evaluate the role of rhomboid excision of the pilonidal sinus with Limberg flap by comparing this procedure with the traditional excision and primary closure.Methods: This prospective study included 60 patients with sacrococcygeal pilonidal sinus. The patients were randomly divided into 2 equal groups. Rhomboid excision of the sinus with limberg flap was performed in 30 patients (group A), and excision of the sinus with primary closure was done to the other 30 cases (group B). Demographic data and surgical outcome were compared between both groups.Results: Group A showed significant early retained to work and significant less postoperative pain than group B (P=0.04 and P=0.02 respectively). Incidence of wound dehiscence, postoperative hematoma and seroma was less among group A but without significant difference. The incidence of postoperative infection and recurrence rate was significantly less in group A than group B (P=0.04 and P= 0.035 respectively).Conclusions: Rhomboid excision and Limberg flap repair is an advantageous and effective modality than simple excision with primary closure in treatment of sacrococcygeal disease. In addition, it is safe and easily procedure; it may be an ideal treatment option in management of pilonidal sinus.

scholarly journals Limberg flap versus primary closure in the treatment of pilonidal sinus: a randomised clinical study

2021 ◽  
Vol 8 (8) ◽  
pp. 2388
Author(s):  
Devaprashanth M. ◽  
Srinivas N. M. ◽  
Akhihlandeshwari N.
Keyword(s):  
Clinical Study ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Wound Dehiscence ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Randomized Clinical Study ◽  
Routine Work ◽  
Group A ◽  
Group B

Background: Pilonidal sinus is a chronic disease usually involving the sacrococcygeal area. Various treatment modalities exist, yet few comparison studies exist to compare the efficacy of one modality over the other. Hence this randomized clinical study was undertaken as an attempt to compare the outcomes of pilonidal sinus following Limberg flap procedure and primary closure.Methods: 60 patients undergoing surgery for pilonidal sinus disease were considered for the study. 30 patients underwent excision and primary closure and 30 patients underwent Limberg flap repair. They were followed up for 1 year. Duration of hospital stay, duration of inability to work, postoperative infection, wound dehiscence, and postoperative recurrence in a follow up period were recorded. Descriptive statistics, chi- square tests and independent t-test are the statistical tools employed.Results: Mean age was 29.83±4.99 years. Male:female ratio was 5.66:1. The mean duration of hospitalization in group A was significantly less (p<0.05) than group B. The patients in group B returned early to routine work (21.56±3.92 days) as compared to 30.5±5.92 days in group A (p<0.05). 5 of 30 patients in group A and 2 of 30 in group B developed surgical site infection. (p>0.05. 4 patients developed wound dehiscence in group A only which was found to be statistically significant.Conclusions: Limberg flap in treatment of pilonidal sinus is associated with shorter hospitalization, early return to routine work and less wound dehiscence as compared with excision and primary closure. Wound infections are comparable with both the modalities.

scholarly journals PILONIDAL SINUS DISEASE: COMPARISON OF EXCISION AND PRIMARY CLOSURE VERSES EXCISION AND HEALING BY SECONDARY INTENTION

1969 ◽  
Vol 2 (1) ◽  
pp. 134-137
Author(s):  
Mohammad Hussain ◽  
Manzoor Ali ◽  
S.M.Naeem ◽  
Nisar Ali ◽  
Muhammad Ismail
Keyword(s):  
Local Excision ◽  
Pilonidal Sinus ◽  
Wide Local Excision ◽  
Primary Closure ◽  
Health Concern ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Secondary Intention ◽  
Group A ◽  
Group B

Introduction: Sacrococcygeal pilonidal disease is a serious health concern because of its associatedcomplications and recurrence. Pilonidal sinus disease is presented with symptoms ranging fromasymptomatic pits to painful draining lesions that are predominantly located in the sacrococcygeal region. Itis characterized by multiple subcutaneous sinuses, containing hairs. The exact etiology of the disease is notknown. Various treatment options are available. The choice of a particular surgical approach depends on thesurgeon's familiarity with the procedure and perceived results. The present study was aimed to compare twotreatment regimens i.e.excision and primary closure verses excision and healing by secondary intention.Patients and methods: The study was conducted in the department of surgery, Saidu Teaching HospitalSaidu Sharif Swat. Forty nine (49) human subjects with informed consent were included in the study.Patients were divided in two groups, depending on their preference and acceptance of the procedure.Patients in group A under went excision of the tract with primary closure of the defect by primary simpleclosure, Rhomboid Limberg flap or by Karydakis procedure. Patients in group B were those in whom sinustracts were excised and wound was left open for healing by secondary intention.Results: Out of the total 49 patients 3 (6.122%) were female. Mean age was 26 years (range 18-40years).Group A comprised of 24 patients in whom wide local excision was performed and wound was closedprimarily while Group B comprised of 25 patients who underwent wide local excision and wound was leftopen for healing by secondary intention. Mean hospital stay of patients in group B was significantly longerthan group A (p=0.002). The mean time for complete healing of the wound after primary closure wasmarkedly shorter.mConclusion: Primary closure of the wound after excision of the sinus tract is preferable over simple excisionand healing by secondary intention.Key words; Pilonidal sinus, primary closure, simple excision.

Comparison of two Different Surgical Modalities in the treatment of Pilonidal Sinus (Primary Closure and Open Technique)

2021 ◽  
Vol 15 (11) ◽  
pp. 2999-3001
Author(s):  
Muhammad Aamir Jamil ◽  
Muhammad Imran Anwar ◽  
Muhammad Waqas Saleem ◽  
Sameen Tahir ◽  
Haroon Javaid Majid
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Sinus Disease ◽  
Open Technique ◽  
Sinus Disease ◽  
Closed Technique ◽  
Secondary Intention ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Pilonidal sinus is disease of young age andits prevalence is higher in men compared to women (almost twice).It is a disease that arises from hair follicles particularly present in the natal cleft. It occurs commonly in Jeep Drivers and hence gets the name from there “Jeep Drivers Disease” and also commonly occurs in Barbers. It leads to formation of abscesses and chronic wounds with discharge and pain. Disease can have huge impact on social life and quality of life. In most cases the treatment is incision and drainage. Study design: It is a case series study. Place and duration of study: Department of General Surgery at Shaikh Zayed Hospital Lahore from January 2019 to January 2021. Aim: To compare the relative effects of open and closed surgical techniques on the recurrence rate, rate of infection and time of healing for pilonidal sinus. Methodology: Patients with pilonidal sinus disease from January 2019 to January 2021 received surgical treatment either excision followed by primary closure as in closed technique (group A) or excision followed by leaving the wound open for healing by secondary intention as in open technique (group B). Surgical management is widely based upon two techniques open and closed. In open technique wound is left open and heals by secondary intention while in closed technique it is closed primarily and heals by primary intention. The better choice between these two techniques is still a topic of debate. Results: The most common age group for pilonidal sinus was between 16-25 years of age. The mean age came out to be 26.7 years. The mean healing time was 15 days in group A and 42 days in group B. The duration of hospital stay ranged between 2-8 days for group A and 5-16 days for group B. Early postoperative complications seen was infection in 1 patient (7.69%) in group A and 5 patients (35.71%) in group B and these cases were managed conservatively.1 (7.69%) case of aseptic gaping of wound after stitch removal was seen in group A and was managed with closed technique. Recurrences reported in group A was 1 case (7.69%) at 6 months and was surgically managed by open technique. There were a total of 4 (28.57%) recurrences which were left open to heal by granulation. Conclusion: It is concluded that better management option for pilonidal sinus disease is primary closure of defect. So it is suggested that management of pilonidal sinus disease should be individualized but preference must be given to closure of wound after excision. Keywords: Pilonidal sinus, Primary Closure, Open Technique.

scholarly journals Pilonidal Sinus Disease: Risk Factors for Postoperative Complications and Recurrence

2012 ◽  
Vol 97 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Akin Onder ◽  
Sadullah Girgin ◽  
Murat Kapan ◽  
Mehmet Toker ◽  
Zulfu Arikanoglu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Disease Risk ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Faculty Department ◽  
Closure Method

Abstract The aim of this study is to analyze the risk factors for complications and recurrence in pilonidal sinus disease. The prospective study consisted of 144 patients with pilonidal sinus disease who were operated on at Dicle University Medical Faculty, Department of General Surgery, between February 2008 and December 2010. Patients receiving the Limberg flap totaled 106 (73.6%), while 38 (26.4%) had primary closure. Postoperative complications developed in 42 subjects (29.2%), and recurrence occurred in 19 (13.2%). The Limberg flap method was statistically considered as a risk factor for postoperative complications (P  =  0.039). Regarding recurrence, family tendency (P  =  0.011), sinus number (P  =  0.005), cavity diameter (P  =  0.002), and primary closure (P  =  0.001) were found to be risk factors. Postoperative complication rate is higher in the Limberg flap method than primary closure method. The risk of recurrence is related to family tendency, sinus number, cavity diameter and anesthesia type and is also higher in primary closure.

scholarly journals Lateral advancement flap for sacrococcygeal pilonidal sinus: reassessment study

2017 ◽  
Vol 4 (6) ◽  
pp. 1968
Author(s):  
Bhavinder K. Arora ◽  
Rachit Arora ◽  
Akshit Arora
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Wound Dehiscence ◽  
Advancement Flap ◽  
Pilonidal Sinus Disease ◽  
Average Hospital ◽  
Sinus Disease ◽  
Aesthetic Results ◽  
Midline Closure

Background: Sacrococcygeal pilonidal sinus disease is treated better with various flaps and primary closure. This study was aimed to describe the lateral advancement flap in surgical treatment of sacrococcygeal pilonidal sinus disease in an effort to redefine the results of this technique. It is a fascio-adipo-cutaneous flap which is advanced from one buttock to opposite across the natal cleft and providing the off midline closure with cleft lift.Methods: The results of this technique were assessed in 65 patients. The technique consists of adequate excisions of sinus, tracts and surrounding inflamed tissue till depth of presacral fascia. The defect was covered with a thick lateral advancement flap and produce an off midline closure and cleft lift.Results: The sixty patients were hirsute males and five were hairless females. The maximum length and breadth covered was 7x5cm. The operative time taken was 40±10 minutes. The average hospital stay was 5 to 7 days. The surgical site infection in 4 patients and wound dehiscence occurred in one patient only. No recurrence was recorded in follow up period of one year.Conclusions: The lateral fascio-cutaneous advancement flap is gaining popularity for its ease of designing and harvesting. The short hospital stay, minimum postoperative complications, no recurrence and acceptable aesthetic results make this a uniformly acceptable technique for surgical primary closure of pilonidal sinus disease.

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