Comparing keystone and Limberg flaps for pilonidal sinus: Does flap choice influence patient satisfaction?

Area of Science:

• Surgical Innovation
• Plastic and Reconstructive Surgery
• Wound Healing

Background:

• Pilonidal sinus disease (PSD) is a chronic condition impacting young adults' quality of life.
• Flap reconstruction techniques are favored for faster healing and reduced recurrence in PSD management.
• Comparative effectiveness of different flap techniques requires further investigation.

Purpose of the Study:

• To compare patient satisfaction and perioperative outcomes between the keystone perforator island flap (KSF) and the Limberg flap (LF) for PSD repair.
• To identify predictors of patient satisfaction following PSD surgery.

Main Methods:

• A randomized comparative study involving 50 patients with simple PSD.
• Patients were equally randomized to undergo either KSF or LF reconstruction post-excision.
• Patient satisfaction assessed at 6 months; perioperative data and complications were recorded.

Main Results:

• The KSF group demonstrated significantly shorter operative times, faster wound healing, and earlier return to activity.
• KSF also resulted in fewer complications (24% vs. 56%) and higher patient satisfaction (96% vs. 72%).
• Wound healing time and return to activity were identified as key predictors of satisfaction.

Conclusions:

• The keystone perforator island flap (KSF) is associated with improved patient comfort, faster recovery, and greater satisfaction compared to the Limberg flap (LF) in PSD treatment.
• Functional recovery parameters are more influential on postoperative satisfaction than the flap type alone.