A novel, double Limberg flap repair for recurrent pilonidal sinus disease
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Published on: September 11, 2021
Emily Leung1, Andrew Finlayson2
1School of Medicine, University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia.
Abstract:
Pilonidal sinuses are chronic inflammation and/or infection of the intergluteal region. Recurrent disease is common and is a source of significant morbidity for affected patients. We present a case of an eighteen-year-old male with extensive recurrent pilonidal disease. A novel technique of a double Limberg flap repair was used, with the vertical axes of each flap positioned to optimise wound tension. The cranio-caudal length of the disease in the natal cleft would have resulted in a large amount of excised normal tissue laterally if a single Limberg flap was considered. To avoid this, we used two Limberg flaps over the craniocaudal length to minimise the laterally excised tissue. The patient made an uneventful recovery with no recurrence at 3 months follow-up. This technique demonstrates the flexibility of the Limberg flap, and that a double flap may be successfully used in extensive disease.
Insights
A novel double Limberg flap technique effectively treated extensive recurrent pilonidal sinuses in a young male. This approach minimized tissue excision, offering a promising solution for complex cases of pilonidal disease.
Area of Science:
- Surgical Innovation
- Wound Management
Background:
- Pilonidal sinuses cause chronic inflammation and infection, frequently recurring and impacting patient well-being.
- Recurrent pilonidal disease presents significant challenges in surgical management.
Observation:
- A case study involving an 18-year-old male with extensive recurrent pilonidal disease.
Findings:
- A novel double Limberg flap repair technique was employed, optimizing wound tension by strategic vertical axis positioning.
- This double flap approach minimized lateral tissue excision compared to a single flap for extensive cranio-caudal disease.
- The patient experienced an uneventful recovery with no recurrence at 3-month follow-up.
Implications:
- The double Limberg flap technique demonstrates adaptability for managing extensive pilonidal sinus disease.
- This method offers a viable alternative to traditional single flap repairs, reducing tissue sacrifice.
- Further studies could explore the long-term efficacy and broader application of this double flap technique.
