A prospective randomized trial comparing modified Limberg flap and cleft lift procedure in the treatment of uncomplicated sacrococcygeal pilonidal disease

Abstract

Background Sacrococcygeal pilonidal disease (SPD) is a common and frustrating problem, but there is still no consensus on the optimal treatment. Many studies recommend off-midline closure if any excision is to be done. The aim of this study was to compare the modified Limberg flap (MLF) and cleft lift procedures. Patients and methods From February 2010 to February 2013, the authors prospectively studied 200 patients with SPD who presented at two hospitals. The patients were randomly assigned to undergo either MLF transposition (n = 100) or the cleft lift procedure (n = 100). Surgical findings, complications, recurrence rates, and degree of patient satisfaction were compared. Results Operation time was longer in the MLF group. There was no significant difference between the two groups in terms of time to complete healing, time off work, complication rate, and recurrence rates. The two groups reported similar rates of satisfaction. Length of hospital stay was slightly longer in the MLF group because of delay in drain removal. During the follow-up period of 21.5 ± 6.8 months for group 1 and 22 ± 7.6 months for group 2, a single case of recurrence (1%) was detected in group 2 versus two patients (2%) in group 1. Conclusion On the basis of the results of this study, the MLF technique and the cleft lift procedure appear to generate comparable results in the management of SPD. Both techniques are safe and easy to learn and have now become our standard procedures for treating chronic, symptomatic SPD.