Limberg flap for pilonidal sinus disease: Our experience

Jethwani, Umesh; Singh, Gurkirat; Mohil, R. S.; Kandwal, Vipul; Chouhan, Jyoti D.; Saroha, Ravi; Bansal, N; Verma, Rachna

doi:10.13172/2052-0077-2-7-731

Cited by 7 publications

(8 citation statements)

References 10 publications

(4 reference statements)

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“…24,26 More serious complications of SPND surgery include flap necrosis, which can occur due to ischaemia/pressure necrosis or tension at the suture line. 27 Since no tension was posed on the suture line in the Limberg flap procedure owing to transposition of flap, none of the patients who had a Limberg flap experienced flap necrosis. On the other hand, patients who underwent Limberg flap had more dissection to create a tension-free flap which resulted in a higher rate of hypesthesia compared with the primary closure group.…”

Section: Discussionmentioning

confidence: 99%

“…29 Reasons for the significant difference in the recurrence rates can be attributed to the tension-free nature of the Limberg flap technique, obliteration of dead space resulting after sinus excision with a well-vascularised flap, and flattening and elimination of the deep midline cleft. 11,27,30 Recurrence after primary midline closure may be attributed to deepening of the natal cleft, which helps to increase anaerobic bacterial content. The vacuum effect created between the buttocks also serves to draw hair and debris into the subcutaneous tissue of the natal cleft as Bascom highlighted.…”

Section: Discussionmentioning

confidence: 99%

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Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

Arnous

Elgendy

Thabet

et al. 2019

annals

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Background Although several surgical techniques for treatment of sacrococcygeal pilonidal sinus (SPND) have been described, there is no consensus on the optimal surgical procedure. In this study we compared excision with primary closure and Limberg flap in the treatment of SPND. Methods This was a prospective randomised clinical trial in patients with SPND who were randomly allocated to one of two groups: group I (excision and primary closure) and group II (Limberg flap technique). The primary outcome of the trial was recurrence of SPND whereas postoperative complications, return to work and cosmetic results were the secondary outcomes. Results Sixty patients were included, with a mean age of 24.1 years and mean body mass index (BMI) of 26.8 kg/m2. Group 1 had significantly shorter operation time than group II. Both groups had similar hospital stay and comparable complication rates (43.3% vs 30%; P = 0.4). Group I had significantly higher recurrence rate (20% vs 0; P < 0.02) and significantly better cosmetic satisfaction score than group II. Being hairy (P = 0.04), positive family history (P = 0.03), diabetes mellitus (P = 0.005) and history of previous surgery for SPND (P = 0.01) were the significant predictors for recurrence. Conclusions The Limberg flap is an effective technique for the treatment of SPND with very low recurrence rate and comparable complication rate and hospital stay to excision and primary closure. Excision and primary closure offered the advantages of quicker healing time, earlier resumption of daily activities, better cosmetic results, which may render it more suitable for patients with low risk for recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

Arnous

Elgendy

Thabet

et al. 2019

annals

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“…In our study males were 18(85.71%) and females were 3(14.29%). Jethuwani U, Singh G showed that male and female pilonidal sinus 74.6% and 25.37% respectively in which male were predominant 13 .…”

Section: Resultsmentioning

confidence: 99%

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

Jahan

Rahman²,

Roy

et al. 2021

J Dhaka Med Coll

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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

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“…They include incision and drainage, cryosurgery, excision with open packing, excision with primary closure, flap surgeries, etc. 4,6,7,[9][10][11][12] Conservative management has limited role for the management of pilonidal disease it can be considered in early stages of disease. In this study only one patient with axillary sinus was managed with antibiotics and regular dressings.…”

Section: Discussionmentioning

confidence: 99%

Study of clinical profile, surgical interventions and outcome in a series of patients with pilonidal disease

Jawade

Bande²

2019

Int Surg J

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Background: Pilonidal disease is a controversial benign condition that often causes nuisance and disability in young adults. Sacrococcigeal region, intergluteal natal cleft, interdigital cleft in barbers and the other hair bearing areas like axilla are found to be involved. Different authors have described different techniques of management of pilonidal disease.Methods: During September 2010 to August 2018 total 24 patients were presented with pilonidal disease and were treated using various surgical interventions. This retrospective study is done to study demographics and clinical spectrum, clinical course, outcome of different surgical interventions done and complications associated with various techniques.Results: Out of 24 patients 18 (75%) were males whereas 6 patients (25%) were females. The age range was 23 to 44 years. Sacrococcigeal region is the most commonly affected region in this series. In this series average duration of presence of pilonidal disease before presentation was 89 days ranging from 4 days to 168 days. One of 24 patients was treated with medical management and rest 23 patient required surgical intervention. Complete excision with rhomboid flap was the most common way of treating pilonidal disease and was used in 10 (41.6%) cases.Conclusions: Pilonidal disease is benign condition seen in young adults associated with morbidity without any mortality. Sinus is the commonest mode of presentation and sacrococcigeal region is the commonest site affected by this disease. Rhomboid flap has a promising result in terms of less post-operative recovery time and post-operative complications.

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Limberg flap for pilonidal sinus disease: Our experience

Cited by 7 publications

References 10 publications

Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

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

Study of clinical profile, surgical interventions and outcome in a series of patients with pilonidal disease

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