Simulation-Based Training in the Limberg Flap Technique for Pilonidal Sinus Disease

Intergluteal pilonidal sinus is a common disease among adults, especially males and is related to high morbidity. The rhomboid flap reconstruction for pilonidal sinus is a transposition flap designed to close a 60° rhombus-shaped defect. This rhomboid flap is basically a chain of connecting equilateral triangles with 60° angles. The planning, outlining, and implementation of the rhombus-shaped flap are very challenging and require technical and cognitive skills to avoid any discrepancies and structural problems in flap raising and reconstruction. This can be achieved by introducing a realistic, simulation-based model of pilonidal sinus disease that allows trainees to practise and become familiar with flap measurements and marking, followed by flap elevation and mobilisation. For this research, a prospective design was adopted to evaluate the effect of simulation-based training on surgical performance in Limberg flap reconstruction for pilonidal sinus disease on real patients. The study aimed to determine the effectiveness of simulation-based training in the Limberg flap technique for pilonidal sinus disease using a task trainer. Key Words: Limberg flap, Pilonidal sinus disease, Simulation, Reconstruction, Rhombus.