Limberg Flap Technique Research Articles

LIMBERG FLAP VERSUS BASCOM CLEFT LIFT TECHNIQUES FOR SACROCOCCYGEAL PILONIDAL SINUS

Objective: The study aims to evaluate and compare the outcomes of two surgical techniques, the limberg flap and Bascom cleft lift, used in the treatment of sacrococcygeal pilonidal sinus. Key metrics for comparison include postoperative complications, hospital stay duration, and surgery duration. Methods: This was a prospective study conducted at ESIC Hospital, Jaipur, involving 100 patients diagnosed with sacrococcygeal pilonidal sinus requiring surgical intervention. Patients were divided into two groups: Group I underwent the Bascom cleft lift procedure (n=40), and Group II underwent the limberg flap technique (n=60). Both groups were evaluated over a period of one and a half years with preoperative assessments and postoperative follow-ups for complications, duration of surgery, and length of hospital stay. Results: The study included 40 patients in the Bascom group (42.5% male, 57.5% female) and 60 in the limberg group (55% male, 45% female). The average surgery duration was significantly shorter for the Bascom procedure (36.73±6.52 min) compared to the limberg flap (74.58±10.10 min). Postoperative complications were higher in the limberg flap group. The Bascom cleft lift patients experienced shorter hospital stays and fewer postoperative issues, including lower rates of discharge and infection. Conclusion: The Bascom cleft lift procedure appears to be superior to the limberg flap in terms of shorter operative time, fewer complications, and quicker recovery. These findings suggest that the Bascom cleft lift could be a more efficient and safer option for the surgical treatment of pilonidal sinus, promoting faster patient recovery with fewer postoperative complications.

Pilonidal sinus hastalığında Rhomboid eksizyon ve Modifiye Limberg flep uygulanan hastalarda tek merkez klinik deneyiminin değerlendirilmesi

Aims: Pilonidal sinus disease (PSD) is a chronic inflammatory disease that is seen especially in young men, is often located in the sacrococcygeal region and negatively affects the quality of life and daily life of the person. In this study, we aimed to share our experience with the literature by examining our clinical approach and results in the patient group who underwent Modified Limberg flap technique electively in PSD.
 Methods: Patients who underwent elective modified Limberg flap application due to PSD in the general surgery clinic were included in the study. Demographic and clinical parameters of the patients were investigated retrospectively.
 Results: The mean age of 76 patients included in the study was 27.5±8.5 years (18-51 years). The median duration of hospitalisation was 2 days. The most commonly preferred prophylactic antibiotic at surgery was cefuroxime + metranidazole combination (60.5%) or cefuroxime alone (32.9%). Drain use was present in approximately 40% of the cases. Subcutaneous tissues were closed with a single layer of polyglactin suture in most cases (94.7%). During the median follow-up period of 12 months, postoperative recurrence was observed in only 6 cases (7.9%).
 Conclusions: Modified Limberg flap technique is a well-defined, safe and feasible surgical method. Since it is an effective off-midline technique, its application by experienced surgeons in complicated and recurrent cases in elective PSD surgery and its transfer to junior and resident surgeons will be effective in terms of moving away from midline techniques.

Limberg Transposition Flap in Primary Pilonidal Sinus- A Case Series

Sacrococcygeal Pilonidal Sinus (PS) is common among the young male adult population. There are multiple treatment options available ranging from non medical and surgical procedures. Medical management is not in vogue. This case series is about 10 patients with a common manifestation of serous discharge from the sinus in the sacrococcygeal region. The patients warranted a definitive cure for their condition. Though not life-threatening, it is socially embarrassing and adversely affects the quality of life in terms of education and livelihood among the young. The Limberg flap technique was advocated in all these patients, only one out of 10 patients showed wound infection. All the patients were satisfied with the surgical outcome. The surgical choices varied from simple excision to flap procedures. Overall the Limberg (rhomboid) flap technique has fewer postoperative complications and low recurrence rate and has a shorter learning curve, and is emerging as the standard of care.

Comparison of Limberg Flap and Karydakis Flap Repair in Pilonidal Sinus Surgery: A Prospective Case-Control Study.

BackgroundPilonidal sinus disease (PSD) is a chronic inflammation and infection of the sacrococcygeal region. It often affects young adult males and produces clinical findings with abscess and discharge in the sacrococcygeal region or painful sinus tract in the natal cleft. The best surgical technique for sacrococcygeal PSD is still disputed. This study aimed to compare the Karydakis flap technique (KFT) and Limberg flap technique (LFT) used in the surgical treatment of the sacrococcygeal pilonidal sinus.MethodologyA total of 140 patients diagnosed with pilonidal sinus between 2010 and 2012 were included in the study. The patients were divided into two groups, namely, LFT (n = 73) and KFT (n = 67). Preoperative findings of the patients, surgical findings, and short and long-term postoperative findings were recorded and statistically compared.ResultsRegarding cosmetic results, the Karydakis flap was better than the Limberg flap with a faster return to normal life. There was no statistical difference between the two groups concerning wound dehiscence, postoperative visual analog scale scores, seroma formation, and recurrence.ConclusionsConsidering the faster return to normal life and greater cosmetic satisfaction of the patients, the KFT should be chosen instead of the LFT as the standard technique in pilonidal sinus surgery.

Limberg flap reconstruction-a reliable and one time solution for chronic recurrent sacrococcygeal pilonidal sinus

Background: Sacrococcygeal pilonidal sinus is a acquired disease of the adult age especially male, with significant morbidity and high recurrence rate. The management of the pilonidal sinus varies from incision and drainage, excision and packing dressing, excision and primary closure, marsupialization, excision and flap cover. Limberg flap technique is single stage procedure and is superior to other technique in terms of less complication and low recurrence rates thus reducing hospital stay, cost and good patient compliance. Aims & Objective: The aim of this study is to discuss feasibility and outcomes of Limberg flap reconstruction in chronic recurrent pilonodal sinus. Methodology: This is a retrospective study involving 14 patient from June 2019 to June 2020; all were men of age group 25 to 40 years with recurrent pilonodal sinus. Result: A total of 14 patients underwent Limberg flap surgery after excision of pilonodal sinus, under spinal anaesthesia. Methylene blue dye was injected in the sinus. Sinus tract with adjacent tissues were excised and beyond the sinus limit to create a rhombic defect. Inferiorly based Limberg flap was planned at the site depending on the pliability of skin. Donor area was closed primarily. Patient was nursed prone.

Limberg Flap Versus Open Procedure in Treatment of Chronic Pilonidal Sinus

Objective: The main purpose of the study is to compare the outcomes of Limberg flap and open procedure to treat the chronic pilonidal sinus. Pilonidal sinus is a disorder of the sacrococcygeal region mostly found in younger folk. Its treatment consists of several methods but in this study, we will go through Limberg flap and open procedure to compare the outcomes of both methods. Study design: Comparative study. Material & Methods: This study was conducted from January 2020 to December 2022. 84 patients included 59 males and 25 females having age between 18 to 40 years were part of the study. All the selected patients were diagnosed with chronic pilonidal sinus and recommended for surgery at sugery Unit1 sir ganga ram hospital Lahore, Pakistan. A total of 84 patients were divided into two groups, group1 consists of 42 patients treated for the Limberg flap technique. Group 2 also contains 42 patients treated for an open procedure. The patients who were suffering from the chronic pilonidal sinus were part of the study while patients who had acute inflammation of the sinus, history of previous treatment of pilonidal sinus were omitted from the study. Results: Out of 84 patients 42 were part of group 1 and the remaining 42 were in group 2. In group1, the mean ±SD age of patients was 26 ± 2.00, 30 (71.4%) males and 12 (28.5%) females. While in group2 the mean ±SD age was 25 ± 3.00, 29 (69%) were males and 13 (30.9%) females were part of this group. The measured p-value for both groups was <0.05. General characteristics of patients show that high percentage of males was affected from pilonidal sinus disease. In group1 patients who had a 2 days stay at the hospital, recurrence was reported in 10 (23.8%) patients with P-value >0.05, irregular scar formation was observed in 16 (38%) patients, the pain was reported in 18 (42.8%) patients, and wound healing after 2 weeks was noted in 20 (47%) patients. In group 2, patients had 6 days stay at the hospital, recurrence was reported in 13 (30.9%) patients with value >0.05, irregular scar formation was observed in 26 (61%) patients, the pain was reported in 34 (80%) patients and wound healing after 2 weeks was noted in 12 (28.57%) patients. p-value was measured <0.05 for all the parameters. Conclusion: Eventually, we concluded significant results of the Limberg flap than the open procedure. A high percentage of complications were measured in patients treated with the open procedure in comparison to the Limberg flap. Keywords: Chronic pilonidal sinus, Limberg flap, open procedure.

Limberg Flap Technique For Pilonidal Sinus Disease Treatment: An Experience Of Hamdard University Hospital.

Pilonidal sinus disease (PNSD) is considered as the challenging disease for surgeons since decades. The term pilo-nidal is derived from Latin meaning "nest of hair". It is a commonly occurring disease usually involved young male adults. It is considered as an acquired condition with unidentified aetiology and pathogenesis. The objective was to observe the results of Limberg's flap operation in patients with Pilonidal sinus disease.. We performed an observational study at Hamdard University Hospital from 1st January 2016 to 31st December 2019 on patients who came to the outpatient department for the treatment of pilonidal sinus diseases and underwent surgery (Limberg's flap) after consent. The patient's presentation varied from single sinus and dry, multiple sinuses and dry, single sinus with serous discharge, single sinus with pus discharge, and pilonidal abscess. Forty-six patients were selected after applying inclusion and exclusion criteria and operated by Limberg's flap technique. Results were observed for postoperative seroma, hematoma, wound infection, persistent pain, and recurrence. Out of 46 patients, 30 (65.21%) were male and 16 (34.7%) were female. 28 patients (60.8%) were between 31-40 years of age and 12 patients (26.08%) were between 41-50 years of age. After performing Limberg's flap procedure, 35 patients (76%) had no complications at all. 2 patients (4.3%) had seroma formation. 4 patients had Hematoma formation (8.6%). Two patients (4.3%) patients developed superficial wound infection. 2 patients (4.3%) had persistent pain after 3 months of the procedure. One patient (2.1%) had recurrence during the follow-up period of 12 months. Limberg's flap operation is associated with low recurrence as well as a low rate of other complications such as seroma or hematoma formation, wound infection, and persistent pain irrespective of the presentation of the pilonidal sinus.

Pilonidal sinus and use of Limberg flap: a three years’ experience from two tertiary care centres of Northern India

Background: Pilonidal sinus is a common chronic inflammatory anorectal condition that arises usually in the natal cleft of the sacrococcygeal region. This disease leads to deterioration not only in professional life of young adults but in their personal life as well. The Limberg flap reconstruction is a frequently used procedure in pilonidal sinus. This aim of this study was to observe the usefulness of Limberg flap technique in treatment of pilonidal sinus in our setup.Methods: This study enrolled a total of 50 patients who underwent Limberg flap surgery for sacrococcygeal pilonidal sinus over a period of 6 years in two different tertiary care hospitals of northern India. Various factors were studied in this study which included age group, gender, operative time, length of hospital stay, post-operative complications, recurrence and time required for return to normal work and activities. All the data was tabulated and analysed.Results: In this study we found that the maximum number of patients were young males in their third decade of life who presented with complaints of discharging sinus, pain and infection. The Limberg flap technique was used in these patients which showed a good outcome as far as complication rates and recurrence rates were concerned. Also return to work in these patients was quite early when compared with other methods in literature.Conclusions: In this study, we can conclude that this procedure is relatively easy to perform with a shorter learning curve, fewer complication rates, faster healing and is associated with a shorter hospital stay.

Limberg Flap Versus Primary Midline Wound Closure in Treatment of Chronic Pilonidal Sinus Disease

Objective: Current study aims to compare the Limberg flap technique with primary midline wound closure to treat the chronic pilonidal sinus disease. Study design: A comparative study was done in Surgery Department Sir Ganga Ram Hospital Lahore from January 2020 to September 2021 Method: The sample size for the study is 60 patients who were regularly visiting the hospital due to PS disease. All the patients were divided into two groups A and B. Group A had 30 patients treated with the Limberg flap method and group B had 30 patients treated with primary midline wound closure. Before starting the treatment a brief description of the treatment was given to all patients and consent was signed from all participants. The final decision for treatment was decided by the team of senior surgeons as well as with help of the patient's own choice. Limberg flap and primary midline wound closure (PMC) were applied to patients who regularly followed the instruction for chronic pilonidal sinus treatment. Primary midline closure was applied on patients who had a cosmetic concern and did not have a recurrence problem. Results: Total 60 patients were divided into two groups, Group A (Limberg flap) had 30 patients in which 25 (83%) were males and 5 (16.6%) females. The mean age for this group was 25 ± 5.00 years. The patients without a previous history of pilonidal sinus disease (primary case) was 17 (56.6%) and the recurrence case was 13 (14.3%). Group B (primary midline wound closure) had 30 patients in which 18 (60%) were males and 12 (40%) females. The mean age for this group was 28 ± 3.00 years. The patient without a previous history of pilonidal sinus disease (primary case) was 28 (93.3%) and the recurrence case was 2 (6.6%). The comparison of 3rd-week outcomes shows that in group A 25 (83,3%) patients had painless walking, 23 (76.6%) patients start their routine work and 26 (86.6%) patients had treatment satisfaction. In group B 21 (70%) patients reported painless walking, 18 (60%) patients started their routine activity and 22 (73.3%) patients shows satisfaction with treatment. Conclusion: Hence we concluded that a better improvement percentage was measured high in group A (Limberg flap) than group B (PMC). Therefore limberg flap is better technique to treat the chronic pilonidal sinus disease. Keywords: chronic Pilonidal Sinus, primary midline wound closure (PMC), Limberg flap

Recurrence is not the Only Problem with Sacrococcygeal Pilonidal Sinus Disease: A Comparison between Microsinusectomy and Limberg Flap Technique

Recurrence is not the Only Problem with Sacrococcygeal Pilonidal Sinus Disease: A Comparison between Microsinusectomy and Limberg Flap Technique

Comparison of the Keystone flap and the Limberg flap technique in the surgical treatment of pilonidal sinus disease.

Pilonidal sinus (PS) disease is a chronic inflammatory disease of the sacrococcygeal region. Although various methods have been described for surgical treatment, there is no consensus on the best surgical technique. The aim of this study was to present the results of a new advancement flap technique named the "Keystone flap (KSF)" and compared with the Limberg flap (LF) technique in pilonidal sinus surgery. A retrospective review was made of 124 consecutive patients surgically treated for PS disease with KSF and LF procedures. Baseline characteristics, operation time, volume of excised specimen, duration of hospitalization, duration of drainage, duration of healing, time to return to work, local complications and recurrence were evaluated and compared between the two procedures. Operation time, healing time, and time to return to work were significantly shorter in the KSF group. Partial wound dehiscense and prolonged wound healing were more common in the LF group. An additional intervention in the operating room was required by 21.1% of the LF group and was a significantly lower rate in the KSF group at 7.5%. There was no significant difference between the groups in terms of recurrence. The KSF procedure seems promising for treating pilonidal sinus disease, with the advantages of shorter operation, healing, and return to work times. It also provides lower partial wound dehiscence and necrosis rates.

Evaluation of Different Methods of Treatment of Pilonidal Sinus; a Randomized Controlled Trial

Background: Sacrococcygeal Pilonidal disease is an infection of the skin and subcutaneous tissue at or near the upper part of the natal cleft of the buttocks. This results from chronic infection of hair follicles and subsequent formation of a subcutaneous abscess. Hair then enters the abscess cavity and provokes a foreign body tissue reaction with chronic suppuration and discharge. The aim of this study was the selection of best method of treatment of pilonidal sinus. Patients and methods: This randomized controlled trials was conducted on 56 patients with the diagnosis of pilonidal sinus disease were admitted to the Department of General Surgery, Zagazig University Hospitals from March 2020 to September 2020. The patients were allocated randomly into four groups, each included 14 patients; Group (1): was Conservative method with medical treatment and drainage if needed. Group (2): were operated by Open technique. Group (3): were operated by Limberg flap technique. Group (4): were operated by Karydakis technique. All patients were subjected to history taking, complete clinical examination, preoperative Laboratory investigations. Results: Recurrence was significantly associated with open and conservative groups while there was only one case in Limberg Group and no case in Karydakis Group. Conclusion: The Karydakis flap procedure should be chosen instead of the Limberg flap for treating uncomplicated Sacrococcygeal pilonidal disease because of its shorter operative time, earlier return to work, faster healing time and significantly higher patient satisfaction.

Sinus laser closure (SiLaC) versus Limberg flap in management of pilonidal disease: A short-term non-randomized comparative prospective study

IntroductionFistula Laser Closure (FiLAC) is a method that was originally applied in the treatment of perianal fistulas. Because of promising results, diode lasers were later on used to treat pilonidal sinus disease in a method called sinus Laser Closure (SiLaC).The aim of this study is to compare between SiLaC and Limberg flap in management of pilonidal disease. MethodsA prospective, nonrandomized comparative study. A short-term follow-up of 71 patients with pilonidal disease was analyzed (24 operated on using the SiLaC technique and 47 using the Limberg technique). With a primary outcome is healing rate and recurrence and a secondary outcome is other measures i.e. complications, hospital stay and postoperative pain. ResultsThe median operative time in the SiLaC group was 26.45 ± 5.41 min (20–35 min) and in the Limberg group 58.63 ± 7.42 min (50–75 min). In the SiLaC group, the primary healing was achieved in 23 out of 24 patients (95.8%) with a total complication rate of 20.83%. There were two cases of recurrence after initial healing in each group. ConclusionSinus laser Closure (SiLaC) is comparable to Limberg flap technique in the terms of healing rate and recurrence with better outcome regarding operative time, hospital stay and post-operative pain.

The short-term results of modified limberg flap in treatment of pilonidal sinus disease

Background: Pilonidal sinus disease is a chronic disease of the sacrococcygeal region, which commonly occurs in young adults. The male population is affected more than the female one. Many surgical techniques have been described in the literature for the treatment of this disease. This study aimed to assess the effectiveness and short term results of the modified Limberg flap technique in the treatment of pilonidal sinus disease. Patients and methods: This randomized clinical trial study was carried out in Zagazig university hospital. It included eighteen patients with pilonidal sinus disease who attended GIT Unit, General Surgery Department, during the period from January 2020 to August 2020. The 18 patients underwent the modified limberg flap procedure. All patients were subjected to Demographic data taking, complete clinical examination and Laboratory investigations. Results: The mean operative time was 63.056±6.673 min. The healing time and duration of work-off were 15.833 ± 2.256 and 16.833 ± 2.256 days respectively. Two patients were complicated. Combined hematoma and dehiscense occurred in one patient (5.6%) and seroma occurred in one patient (5.6%). No patients had a recurrence. Conclusion: modified Limberg flap technique showed early healing, short duration of work-off, and a low rate of complications and recurrence.

A study on different modalities of treatment for pilonidal sinus

Background: Excision with lay open method and excision with primary closure (simple closure, z-plasty, limberg flaps are both radical methods for treating pilonidal sinus. The ideal operation should be simple and should not require a prolonged stay, have low recurrence, failure rate and post-operative complication. Aim& Objective: The main objective of the present study to compared different techniques for treatment of sacrococcygeal pilonidal sinus. Methodology: It was a cross sectional study. The materials for this study was taken from the patient admitted to Owaisi hospital from Jan 2013-Dec 2014 (2yr period) Twenty eight patients with pilonidal sinus who were admitted to Owaisi hospital Results: In the present study, 15 out of 28 cases were treated by excision and lay open method. The mortality was nil, but the recurrence was 1 and 2 failures were noticed (totally 22.6% failure) in terms of morbidity. Patients abstained from work till the wound healed i.e. 44-68 days(average 49.5 days).The remaining 13 cases were operated by excision and primary closure (simple closure, z-plasty, limberg flap method) out of which 8 cases were treated with z-plasty and 2 cases with simple primary closure and 3 cases with limberg flap method. The mortality was nil, the recurrence rate and post-operative complications were nil and all patients returned to work early within 7 days. Conclusion: Finally we concluded that all cases where closure is possible should be treated with different closure techniques (simple closure, z-plasty, limberg flap). Deep gluteal cleft is flattened with z-plasty and limberg flap technique. Hence the suction effect is obliterated. All predisposing factors are countered by flap technique hence flap techniques are ideal for treatment for pilonidal sinus.

LIMBERG FLAP VERSUS EXCISION WITH PRIMARY CLOSURE IN PILONIDAL SINUS

Background: Pilonidal sinus disease (PNS) is a potentially debilitating condition. It was first described by Anderson in 1847 and is often seen in the intergluteal region and can cause loss of work time. Several procedures have been advocated for treatment and the fact that no single procedure is superior in all respect. Objective: This study aimed to compare the outcomes of excision and primary closure versus Limberg-flap (LF) techniques. Patients and methods: This randomized, prospective observational study was carried out at the Department of surgery, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt over 2 years (January 2018 to January 2020) on 60 patients out of which 30 underwent rhomboid excision with Limberg flap reconstruction (group A) and 30 underwent excision with primary closure (group B). Post-operative follow up was done till 12 months and complications were recorded. Results: There was no statistical difference between the two groups as regards demographic data, partial wound dehiscence, and time to complete healing. There was a statistically significant difference between the two groups as regards wound complications (3.3% in group A versus 20.0% in group B) and the recurrence rate (13.3% in group B versus 0% in group A). Conclusions: Limberg flap method for the pilonidal sinus is a better choice than midline closure after elliptical excision in terms of postoperative wound complications and recurrence.

Treatment of young patients with pilonidal sinus disease with the original (unmodified) Limberg flap standardized for the first time.

Pilonidal sinus disease (PSD) is commonly seen in young adults but may also affect adolescents. Our goal was to present results from operated patients, with a focus on the original Limberg flap, which we standardized for the first time. This study was a retrospective review of 60 teenage patients who underwent surgery in a single pediatric surgery center over approximately 15years. Of the 60 patients, 33 (55%) were male and the mean age was 14.20±1.31 (9-17) years. After pilonidal sinus excision, primary repair and Limberg flap were performed in 45 (75%) and 15 (25%) patients respectively. There were no complications in the patients who underwent the Limberg flap technique, whereas 49% of the patients who underwent primary repair exhibited complications. The mean follow-up was 6.7±4.8years. We standardized the Limberg flap for the first time in children with measurements and consider that it meets expectations: it is not difficult to perform, it has low complication and recurrence rates, it requires an acceptable period to return to normal activities, and gives satisfactory cosmetic results. We did not identify any complications in patients treated with the Limberg flap excision and post-operative epilation. We consider that findings achieved by the treatment of original, standardized Limberg flap excision is comparable with all of the treatment methods reported in the literature related with children.

SBU KOCAELI DERINCE TRAINING AND RESEARCH HOSPITAL, DEPARTMENT OF PEDIATRIC SURGERY, DERINCE, KOCAELİ, TURKEY

SBU KOCAELI DERINCE TRAINING AND RESEARCH HOSPITAL, DEPARTMENT OF PEDIATRIC SURGERY, DERINCE, KOCAELİ, TURKEY

Treatment of Pilonidal Sinus by Limberg Flap-Only Hope of Cure (Study of 50 Cases)

Background : Pilonidal sinus was first described by Dr. A.W. Anderson in 1847 and is often seen in the intergluteal region. It is a disease of mainly younger male and rarely affects after 40. Main causes for the formation of this sinus are hirsutism, sweating in the area, repeated maceration due to trauma, leading to breakage of the skin barrier, attracting hair inside which initiates a foreign body reaction leading to infection with abscess or sinus formation. Most common embarrassing situation is discharging sinus. The diagnosis is mainly on clinical ground. Though there are a lot of modalities of treatment but recurrence is still a challenge. We have adopted Limberg flap technique since 2012 with a least recurrent chance.
 Objectives : To prove that this procedure will be end up with lower morbidity & least chance of recurrence
 Methods : This prospective study was done jointly by the Department of Surgery of Central Medical College and Comilla Medical College Hospital. In this series 50 patients were selected from July 2012 to June 2017.
 Results : Out of 50 patients operated by Limberg flap technique 42(84%) were males and 8(16%) were females. Mean age was 27.3 years (range 18–37years). Of them,12(24%) were driver, 6(12%) police, 6(12%) teacher, 6(12%) student, 5(10%) worker, 4(8%) millitary army, 4(8%) housewife, 4 (8%)service holder, 2(4%) computer operator, 1(2%) doctor and 1(2%) were barber. In our study most common mode of presentation were chronic discharging sinuses 15(30%), beside this 12(24%) had multiple sinuses, 10(20%) had multiple pits,7(14%) had acute abscess and 6(12%) had unpleasant smell. Associated hirsutism were present in 30(60%) and absent in 20(40%) patients. One (2%) male patient had wound gap & discharge and six(12%) patients had flap edema. We have found no recurrence in follow up period.
 Conclusion : Pilonidal sinus is a notoriously recurrent disease, so treatment by this flap technique is the only hope of cure with lower morbidity.
 Journal of Surgical Sciences (2018) Vol. 22 (2) : 89-94

Comparison of classical versus modified Limberg flap techniques in pilonidal sinus surgery

Comparison of classical versus modified Limberg flap techniques in pilonidal sinus surgery