Comparison of primary closure + Limberg flap combination with primary closure and Limberg flap alone in the treatment of pilonidal sinus disease: a retrospective study

Abstract

Objective: There are no definite rules for the treatment of pilonidal sinus disease (PSD). The aim of this study was to compare the primary closure (PC)+ Limberg flap (LF) combination with PC and LF alone in the treatment of PSD.Methods: Patients with PSD who underwent PC, LF and PC+ LF between 2013–2020 in Tokat State Hospital were included in the study. Age, gender, sinus classification, and recurrence were evaluated. PSD staging was performed according to the Tezel classification. Patients were divided into three groups as PC, LF and PC+LF according to type of operation.Results: Ninety-four patients (mean age of 26.5 ± 6.9 years) were included in the study. Group PC consisted of 17 male and 7 female patients with a mean age of 27.04 (18–44) years; group LF comprised 24 male and 12 female patients with a mean age of 27.39 (18–46) years and group PC+LF comprised 22 male and 12 female patients with a mean age of 25.26 (18-47) years. There were no significant differences between groups in terms of age and gender (p=0.36, p=0.87, respectively). The mean operative time was significantly longer for the LF group than the PC+LF group (p<0.001). Recurrence rate was 41.7% in the PC group, compared to 17.6% for the PC+LF group (p=0.04). There were no significant differences between LF and PC+LF group regarding recurrence (p=0.43).Conclusion: The PC+LF combination provided less recurrence compared to PC and shorter operation duration compared to LF.