Lower recurrence rate for Limberg vs. V-Y flap for pilonidal sinus

Area of Science:

• Plastic Surgery
• Surgical Oncology

Background:

• Pilonidal sinus disease lacks a standardized surgical treatment.
• Flap reconstruction is utilized for complex cases.

Purpose of the Study:

• To compare the outcomes of Limberg fasciocutaneous transposition flap versus V-Y fasciocutaneous advancement flap for pilonidal sinus treatment.
• To evaluate recurrence rates and complications associated with each flap technique.

Main Methods:

• Retrospective analysis of 111 patients undergoing pilonidal sinus excision with flap reconstruction.
• Patients were divided into two groups: Limberg flap (n=66) and V-Y flap (n=45).
• Outcomes assessed included operative time, complications, time off work, and recurrence rates.

Main Results:

• No significant differences were observed in gender, infection history, operative duration, analgesic requirements, wound complications (necrosis, seroma, infection), or time off work between the two groups.
• The recurrence rate was significantly lower in the Limberg flap group (1.5%) compared to the V-Y flap group (11.1%) (P=0.039).
• Mean follow-up periods were comparable: 45.4 months for Limberg flap and 48.8 months for V-Y flap.

Conclusions:

• Limberg flap reconstruction is associated with a lower recurrence rate in pilonidal sinus cases compared to V-Y flap reconstruction.
• The Limberg flap should be considered the preferred method for flap reconstruction in pilonidal sinus disease due to its superior recurrence profile.