MANAGEMENT OF SACROCOCCYGEAL PILONIDAL SINUS WITH LIMBERG FLAP - RESULTS OF 55 PATIENTS
Abstract
Introduction: The treatment of sacrococcygeal pilonidal sinus is a surgical challenge and no gold standard therapy is defined. Excision and reconstruction with Limberg flap is an excellent choice as an alternative to classical methods with faster recovery and fewer complications and recurrence.
Material and Methods: We performed a retrospective analysis of sacrococcygeal pilonidal sinus treated with Limberg flap between 2007 and 2014 in two tertiary-care centers. We analyzed demographic data, surgical procedure, complications, recovery time and recurrence.
Results: 55 patients were treated during this period, with a median age of 28 years and male preponderance (82%). Forty-eight patients (87%) were treated with classical Limberg flap and the others (13%) with modified/ lateralized Limberg flap. The final suture was removed on average after 14 days and patients were able to return to work after 15 days. Surgical site infection occurred in 4 patients and recurrence occurred also in 4 patients. The frequency of immediate complications was superior in patients treated with lateralized Limberg flap and occurred in 57% of these patients. The recurrences occurred only in patients treated with classical Limberg flap on average 2.5 years after surgery.
Conclusions: The Limberg flap technique has advantages over excision with primary closure or marsupialization, with better complications and recurrence profile. In contrast with published literature, we found more complications in patients treated with modified Limberg flap. Due to its advantages, Limberg flap technique plays an important role in the treatment of pilonidal disease, in a young working population.
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