Efficacy of modified Limberg flap in surgical treatment of infected pilonidal abscess: a case–control study

Abstract

Despite several surgical techniques in the treatment of pilonidal sinus, the ideal management is still under debate. Recently, Limberg flap has revealed promises owing to a lower recurrence rate. Our study aimed to assess mid-term outcomes of Limberg flap in patients with pilonidal abscesses. Through a prospective case–control study, we enrolled 90 consecutive patients with pilonidal disease attending department of surgery in one of the university hospitals in Tehran, Iran, between January 2010 and April 2011. Patients with simple sinus (control group) underwent wide excision of the sinus, while those with infected pilonidal abscess received incision and drainage of the abscess and then excision (case group), and ultimately all the patients were treated with Limberg flap. Patients were followed by regular outpatient visits at 1 week, 2 weeks, 1 month, 6 months, and 1 year. Of 90 patients, 17 were in the case group (18.88 %) and 73 in the control group (81.12 %). All patients were treated with Limberg flap and then followed at regular outpatient visits for a median of 11 months. With regard to the early complications, hematoma occurred in one patient (1.4 %) and infection in three patients (4.1 %) of the control group, while late complications occurred only in two patients of the control group as paresthesia, which did not differ significantly. This study showed that Limberg flap is effective in the surgical treatment of infected pilonidal abscess, with desirable mid-term outcomes.