Comparative study between Limberg flap and local rotation flap for pilonidal sinus, as a new modified technique

Abstract

Introduction Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Treatment varies according to the clinical presentation of the disease. Although many surgical methods have been suggested, an ideal method is still lacking because of high recurrence rates. Recurrent disease causes significant morbidity and consequent time off work. Aim The aim of this study was to assess the role of the local rotation flap in promoting primary healing in pilonidal disease and to evaluate morbidity and recurrence in comparison with Limberg flap. Patients and methods This prospective study was conducted at Al-Azhar University Hospitals, from April 2015 to July 2018. It involved 80 patients with pilonidal disease. There were 56 males and 24 females aged between 21 and 42 years old. They were divided randomly into two groups, with 40 patients each. Group A underwent Limberg flap, whereas group B underwent a local rotation flap closure for sacrococcygeal pilonidal sinus. Results The operative time was ∼1.5 h in group A, whereas in group B was ∼45–60 min. The duration of hospital stay was 1 day, as all patients were discharged on the same day of surgery in both groups. In group A, there was no wound infection, but two cases had wound dehiscence, one case flap necrosis, and two cases with seroma after removal of drain. In group B, there was no wound infection, flap necrosis, or wound dehiscence, but there were six cases with seroma in the follow-up period. There was one case of recurrence in group A and no recurrence in group B. Conclusion This study favors the local rotation flap for sacrococcygeal pilonidal sinus because it had the same outcomes as in Limberg flap, in addition to its simplicity and short operative time.