Outcome of dufourmentel flap versus conventional rhomboid (Limberg flap) in the treatment of complex pilonidal sinus: a randomized controlled study

Abstract

Background Management of pilonidal disease lacks a single optimal treatment strategy, and recurrence is a problem for both the patient and the surgeon. Various flap-based treatment approaches are available for the treatment of such problems. This study aims to compare the outcome of dufourmentel flap versus conventional rhomboid in complex pilonidal diseases. Patients and methods The present randomized controlled study included 64 patients with complex pilonidal sinus, who were randomly divided into two groups: group A (n=32) patients underwent a dufourmentel flap while group B (n=32) patients underwent conventional rhomboid (Limberg flap). Follow-up was planned for early postoperative complications and recurrence as well as the aesthetic outcome. Results The mean age was 25.3±7.4 and 25.8±5.8.years in groups A and B, respectively. There was a statistically significant longer flap in group A when compared with group B (P=0.04). The mean operative time was 39.3±4.8 and 43±4.4 in groups A and B, respectively. Postoperative follow-up revealed a higher rate of complications in group B than in group A with a statistically significant difference in postoperative infection/discharge, hematoma, seroma, and partial flap loss. Conclusion Due to its adaptability, repeatability, clear, and predictable closure of the defect, and low recurrence rate, the authors suggest the dufourmentel flap as a suitable approach in the treatment of difficult and recurrent cases.