Modified Limberg's flap versus primary closure for treatment of pilonidal sinus disease: a comparative study

To compare the outcome of Rhomboid excision and Modified Limberg's flap closure with excision and primary closure for the treatment of Sacrococcygeal Pilonidal sinus.

The study was conducted at the Surgical Department of Mayo Hospital, Lahore, from 2009 to 2012. A total of 60 patients of pilonidal sinus were randomly divided into two equal groups. The patients were operated under general anaesthesia in prone position by Rhomboid excision and Modified Limberg's flap closure with a closed suction drain in group 1, and excision and primary closure over a drain in group 2. Patients were followed up for 12 months for surgical complications of the treatment. SPSS 17 was used for statistical analysis.

In group 1 there were 27(90%) males and 3(10%) females, while group 2 had 28(93.3%) males and 2(6.7%) females. The infection rates were observed to be 2(7%) in group 1 and 8(26.6%) (p<0.038) in group 2. The recurrence rate was only 1(3.3%) in group 1 compared to 4(13.3%) in group 2. Average hospital stay was 1.63±0.67 days group 1 and 2.8±1.24 days in group 2.

Modified Limberg's flap closure is an effective treatment modality for pilonidal sinus disease with 1.5 times less infection rate, 4 times less recurrence rate and 40% in-hospital time.