Comparison of excision with primary repair versus Limberg flap

Pilonidal disease is a common chronic disorder, mostly affecting young adult males. Different hypotheses have been introduced for this disease, but acquired pathogenesis is the most acceptable one. Furthermore, different types of intervention are performed based on its pathogenesis. The aim of this study was to compare excision with primary repair versus the Limberg flap.

One hundred patients, who were enrolled in this study were randomly divided into two groups of 50 patients. One group underwent excision with primary repair and the other group rhomboid excision with the Limberg flap. Then the demographic characteristics, early and late complications, comfort and pain score on the first and fourth postoperative day, hospital stay, time of return to work, and patient satisfaction were compared. P < 0.05 was considered statistically significant.

The mean age was 24 years and the male to female ratio was 4:1. There was no significant difference between the two groups in terms of demographic characteristics, operation time, early complication rate and recurrence. But significant difference was observed in return to work, first pain-free toilet sitting, pain score and patient satisfaction.

It seems that the Limberg flap has similar complications as the primary repair method, but earlier return to work and less hospital stay, lower pain score and higher comfort and satisfaction were the advantages of the Limberg flap method. Thus, this method is recommended for the treatment of primary pilonidal disease.