How Effective and Safe is Limberg Flap in the Treatment of Pilonidal Sinus

INTRODUCTION: A pilonidal sinus (PS) is a disease that arises from chronic irritation and secondary inflammation of hair follicles located in the sacrococcygeal and natal region. The purpose of this study was to determine the results of patients who underwent Limberg flap with the diagnosis of PS and the effectiveness of Limberg flap.
METHODS: The files of patients who were operated in our clinic between January 2015 and October 2019 with the diagnosis of PS were examined retrospectively. In addition to the demographical features of patients who have applied Limberg flap, type of the disease, the duration of the surgery, the hospitalization duration, the existence of complications after the surgery, and recurrence of the disease were analyzed.
RESULTS: Of 212 patients included in the study, 158 (74.5%) were male and 54 (25.4%) were female. The average age of the patients was 26.3 (18–44). 8 (3.73%) of the patients had Type-1, 48 (22.6%) had Type-3, 101 (47.6%) had Type-4, and 29 (13.6%) had Type-5 diseases. Patients who had Type-5 disease were found to recur after different surgical techniques. Due to the Type-2 disease, 26 (12.2%) patients underwent abscess drainage and Limberg flap approximately 3 weeks later. The average surgery period was 42.5 (32–78) min. Wound infection has been seen in 12 (5.6%) patients and wound dehiscence has been seen in 7 (3.3%) patients. Wet dressing and primary repair were performed at the lower edge of the flap because of the local recurrence to 5 (2.3%) patients.
DISCUSSION AND CONCLUSION: Nowadays, though it is stated that minimal invasive methods are effective for the treatment of the disease, we believe that surgical methods are more appropriate for the treatment. Furthermore, the surgical method to be chosen should be Limberg flap that is a reliable and effective procedure with its low recurrence rates, short hospitalization period, and low rate of complications.