Modified Limberg Transposition Flap for Sacrococcygeal Pilonidal Sinus

Menteş, B. Bülent; Leventoğlu, Sezai; Cıhan, Alper; Tatlıcıoğlu, Ertan; Akın, Murat; Oğuz, Mehmet

doi:10.1007/s00595-003-2725-x

Cited by 127 publications

(139 citation statements)

References 25 publications

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“…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.…”

supporting

confidence: 62%

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

et al. 2017

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Background: Best surgical treatment of pilonidal sinus is always challenging for a surgeon in term of recurrence. Evaluation 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 of sacrococcygeal pilonidal disease.Methods: In this prospective randomized study of 75 patients of sacrococcygeal pilonidal sinus were divided into 3 equal groups through randomly assigning the type of surgery. 25 patients of each group. Group I was operated by primary midline closure after elliptical excision, Group II rhomboid excision with limberg flap reconstruction and Group III open excision and healing by secondary intention.Results: Data was assessed between three groups in term of operative time, healing time and recurrence over a follow up period of 1 year. Mean operative time in group I (primary midline closure after elliptical excision) was 38.7±5.1 minutes, group II (Rhomboid excision with Limberg flap reconstruction) was 124.2±5.6 minutes, group III (Open excision and healing by secondary intention) was 20.6±5.6 minutes. Mean healing time for group I was 19.0±7.4 days, for group II was 17.0±8.0 days and for group III was 60±9.6 days. Recurrence occurred in 3 patients in group I and nil in group II and III.Conclusions: Rhomboid excision with limberg flap reconstruction is better choice than primary midline closure after elliptical excision and open excision in terms of healing time and reoccurrence in cases of sacrococcygeal pilonidal sinus.

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supporting

confidence: 62%

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

et al. 2017

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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To compare elliptical excision with primary midline closure and rhomboid excision with limberg flap reconstruction techniques for the sacrococcygeal pilonidal sinus. This prospective randomized study of 80 patients of sacrococcygeal pilonidal sinus was performed in SKIMS medical college from 2004 to 2007. After assigning patients randomly to either of the surgical groups, group A patients (40/80) were operated by using rhomboid excision with limberg flap reconstruction whereas group B patients (40/80) were operated by using elliptical excision with primary midline closure. Data was compiled in terms of operative period required, immediate post operative complications, post operative pain (VAS scores), work-off period, hospital stay and recurrences over a follow up of 3 years for the two study groups. Data thereby collected was analyzed by using Microsoft excel. The parameters in which the two techniques were found to differ significantly were work-off period, immediate post operative complications profiles and recurrence rates. Rhomboid excision with limberg flap reconstruction technique surely outscores elliptical excision with primary midline closure in certain important parameters. While facing a patient with uncomplicated sacrococcygeal pilonidal sinus, instead of, which procedure for the patient? Surgeons should pose the question why not rhomboid excision with limberg flaps reconstruction?

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“…Aslam had 110 patients, with 5 of them having complications and 1 recurrence [19]. Mentes and Urhan were other studies [20,21]. In our series we had two complex wound infections, three minor flap edemas, and one flap tip discharge-all healed in due time.…”

Section: Discussionmentioning

confidence: 70%