Sacrococcygeal pilonidal sinus disease with Limberg flap repair

Kapan, Murat; Kapan, Selin; Pekmezci, Salih; Durgun, Vedat

doi:10.1007/s101510200005

Cited by 74 publications

(79 citation statements)

References 14 publications

(37 reference statements)

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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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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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“…The latter technique results in significantly higher recurrence rates as compared to the former (7-40% and 0-3%, respectively) (5-7). Limberg technique seems to have the lowest wound related complication and recurrence rate (8)(9)(10)(11). However, excision and primary midline suturing has been the most frequently used method with the highest postoperative complication and recurrence rates (12).…”

Section: Introductionmentioning

confidence: 99%

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

Uçar¹,

Cartı²,

Oymacı³

et al. 2016

UCD

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Objective: Pilonidal sinus disease (PSD) effects mainly young men's social and work life with frequent recurrence rate. Reoperation for unimproved or recurrent disease is somehow troublesome. Surgeons may think that changing treatment strategy after recurrence may prevent further relapses of PSD. We analyzed patients with recurrent pilonidal sinus to determine their predisposing features for recurrence and the outcomes of the preferred surgical methods. Material and Methods:From 2007 to 2012, out of 95 recurrent pilonidal sinus disease (rPSD) patients, 62 operated cases were included and examined retrospectively. Their retrospective data were examined for demographics, 1 st and 2 nd operation types, patient satisfaction and pain scores. For cases with insufficient preoperative or postoperative data, phone call and interviews were done to obtain data. Some were kindly invited to the outpatient examination. Student's t test, Mann-Whitney U test, and Kaplan Meier test for disease free survival time were used where appropriate. P values less than 0.05 were accepted to be statistically significant. Results:Total of 62 rPSD patients were examined. Male:female ratio was 2.9:1. The mean age after 1 st and 2 nd operations were 24.7 and 28.1 years, respectively. One and five-year recurrence rates were 33.9% and 66.1%, respectively. The mean interval between the 1 st and 2 nd operations was 45.6 months. Excision and midline closure was the most frequent type of operation followed by flap reconstructions and excision-lay open procedures. The 1 st operation types of rPSD cases were different from that of 2 nd operations. Pain perception and satisfaction scores were better in flap reconstruction groups. Conclusion:Reoperative surgery of rPSD is satisfactory with certain precautions. Relapses after flap reconstruction procedures with a well-being period should be referred as second primary disease. Changing surgical strategy is not always indicated as some patients with recurrence have relapsing or second primary disease that have distinct clinical course. Re-flap surgery after any kind of relapse is well appreciated.

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Sacrococcygeal pilonidal sinus disease with Limberg flap repair

Cited by 74 publications

References 14 publications

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

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

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

Recurrent pilonidal disease surgery: Is it second primary or reoperative surgery?

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