Rhomboid excision with modified Limberg flap in the treatment of sacrococcygeal pilonidal disease

Abstract

Background: Optimal treatment for sacrococcygeal pilonidal disease has not been determined because of high complications and recurrence rate. We conducted this study to evaluate the effectiveness of rhomboid excision with modified Limberg flap in the treatment of sacrococcygeal pilonidal disease. Patients and Methods: Twenty one patients with pilonidal sinus of both primary and recurrent presentations were operated from July 2011-July 2012. Following rhomboid excision of the pilonidal sinus a modified Limberg flap was performed and used to cover the defect under spinal anesthesia. Cases were followed up for median of 4 months post operatively. Results: Of the 21 cases, 16 (76%) had no post operative complications, either during their stay in the hospital (3-9 days) or during the follow up period (4 months). Five cases presented with different complications. One patient had recurrence, two had complications of both wound infection and wound dehiscence and underwent second operation under local anaesthesia. Conclusion: Rhomboid excision with modified Limberg flap is a promising surgical technique proved to be safe and effective in the treatment of both primary and recurrent pilonidal sinuses with less post-operative complications, short hospital stay and low recurrence rate.