Combined Horizontal Split Gluteus Maximus Muscle Flap and Fasciocutaneous Limberg Flap for Reconstruction of Recurrent Sacrococcygeal Pilonidal Sinus

Abstract

Background: Pilonidal sinus is a chronic recurrent medical disease. The exact etiology of the disease is still unknown but the most accepted theory is an acquired condition characterized by infected sinus in the natal cleft area contains lifeless hair tuft. Multiple techniques were prescribed for its treatment however the ideal method still not yet defined. Patients and Methods: Fifty eight male patients who underwent excision of their recurrent pilonidal sinus disease and the resulting defects were reconstructed using combined horizontal split gluteus maximus flaps and rhomboid flaps. Outcomes were revised from patient's files case and followed up in outpatient clinic and via questionnaires. Results: The mean hospital stay was three days. The mean time to return to work was 16 days. Partial wound dehiscence's occurred in two patients. Distal end flap necrosis occurred in one patient. There were no flap losses, no recurrences, no infections, no loss of function and no seromas during a mean follow-up period of 24 months. All patients were satisfied with the results. Conclusion: In comparison with other techniques, it has a comparable operative time and hospital stays. It has minimal and acceptable complication rates and no recurrences. We can conclude that this procedure of combined split gluteus maximus muscle flap and rhomboid flap provides an excellent, effective, easy and feasible method of choice for reconstructing defects of recurrent pilonidal sinus disease.