Long-Term Results of Limberg Flap Procedure for Treatment of Pilonidal Sinus

Abstract

The Limberg flap procedure is a good treatment choice for pilonidal sinus because of its low complication rate, the short time to return to normal activity, and good long-term results. This procedure has good postoperative results and is a comfortable surgical method for the patient.

Prospective randomized study of surgical treatment of pilonidal sinus; primary midline closure after elliptical excision versus rhomboid excision with limberg flap reconstruction versus open excision and healing by secondary intention

“…Literature has documented a recurrence rate of 0-3% for Limberg flap against a significantly high recurrence of 7-42% for primary closure. 26,[33][34][35][36][37][38] Our study also three recurrences in primary closure and nil in case of Limberg flap group and nil in 3 rd group where healing was by secondary intention. Our results also support those patients in primary closure group walked freely without significant pain after a relatively longer period than patients treated with flaps because of the tension created by the primary suture technique.…”

Elliptical Excision with Midline Primary Closure Versus Rhomboid Excision with Limberg Flap Reconstruction in Sacrococcygeal Pilonidal Disease: A Prospective, Randomized Study

“…So, looking that way one expects flap procedures to combat the disease recurrence better than excision with simple closure, keeping in view extensive dissection of the sinus tracts and the shallower cleft that flap procedures provide. Literature has documented a recurrence rate of 0-3% [2][3][4][5][6] for Limberg flap against a significantly high recurrence of 7-42% [7,8] for primary closure. Outcome of our study in terms of recurrence of the sinus is the same as reported by other studies, namely, three recurrences for the primary closure group against zero recurrence of the Limberg flap group.…”

“…Published data reveal 7-17.5 days [6,12,13] work off period for the Limberg flap and 21-23 days [11,14] for the midline primary closure. In keeping with these results, our study also documented a less work off period for the Limberg flap group (mean 10.80±3.25; range 7-15 days) as compared to the primary closure group (mean 12.52±1.87; range 8-17 days) and the difference has been found to be statistically significant with a p value of 0.0048.…”

“…Such differential tendencies for the two procedures are accounted by the extensive dissection for the flap procedure and strained wound at the basin of natal cleft for the primary midline closure. Published studies documented a wound infection rate and a wound disruption rate of up to 12.4% [16] and 5-10% [15,17], respectively, for the primary midline closure technique, while published values of such parameters for the Limberg flap group are 1.5-6.5% [4,6,15,18] and 0.9-3.9% [18,19], respectively. In keeping with the published literature, our study observed an immediate complication rate of 20% (suppurative wound infections or wound disruptions 7/40 and hematoma or seroma 1/40) and 12% (suppurative wound infections 2/40 and hematoma or seroma 3/40) for the primary midline closure group and the Limberg flap group, respectively.…”

“Flag Excision and Flap” Procedure: a Novel Modification for Off-Midline Closure After Pilonidal Sinus Excision

“…The rhomboid or Limberg flap involves midline excision of the pilonidal disease to the presacral fascia with fasciocutaneous coverage [7,[28][29][30]. It is a rotational flap and results in flattening of the gluteal cleft.…”