JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

eISSN: 2717-7505
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Evaluation of single center clinical experience in patients undergoing modified Limberg flap technique in pilonidal sinus disease
Abstract
Aims: Pilonidal sinus disease (PSD) is a chronic inflammatory disease that is seen especially in young men, is often located in the sacrococcygeal region and negatively affects the quality of life and daily life of the person. In this study, we aimed to share our experience with the literature by examining our clinical approach and results in the patient group who underwent Modified Limberg flap technique electively in PSD. Methods: Patients who underwent elective modified Limberg flap application due to PSD in the general surgery clinic were included in the study. Demographic and clinical parameters of the patients were investigated retrospectively. Results: The mean age of 76 patients included in the study was 27.5±8.5 years (18-51 years). The median duration of hospitalisation was 2 days. The most commonly preferred prophylactic antibiotic at surgery was cefuroxime + metranidazole combination (60.5%) or cefuroxime alone (32.9%). Drain use was present in approximately 40% of the cases. Subcutaneous tissues were closed with a single layer of polyglactin suture in most cases (94.7%). During the median follow-up period of 12 months, postoperative recurrence was observed in only 6 cases (7.9%). Conclusions: Modified Limberg flap technique is a well-defined, safe and feasible surgical method. Since it is an effective off-midline technique, its application by experienced surgeons in complicated and recurrent cases in elective PSD surgery and its transfer to junior and resident surgeons will be effective in terms of moving away from midline techniques.

Keywords : Pilonidal sinus disease, modified Limberg flap, pilonidal sinus excision

Download Article


1. Kanat BH, Sözen S. Disease that should be remembered:sacrococcygeal pilonidal sinus disease and short history. World JClin Cases. 2015;3(10):876-879. doi: 10.12998/wjcc.v3.i10.876
2. Kober MM, Alapati U, Khachemoune A. Treatment options forpilonidal sinus. Cutis. 2018;102(4):E23-E29.
3. Kumar M, Clay WH, Lee MJ, Brown SR, Hind D. A mappingreview of sacrococcygeal pilonidal sinus disease. Tech Coloproctol.2021;25(6):675-682. doi: 10.1007/s10151-021-02432-9
4. Sarı R, Akbaba S, Gündoğdu RH, Yazıcıoğlu MÖ. Comparisonof VY flap and Limberg flap methods in pilonidal sinus surgery.Turk J Colorectal Dis. 2019;29(2):69-74. doi:10.4274/tjcd.galenos.2018.10437
5. Danilov MA, Saakyan GG, Leontyev AV, Baichorov AB, AbdulatipovaZM. Rezul'taty khirurgicheskogo lecheniya epitelial'nogokopchikovogo khoda s ispol'zovaniem plastiki po Limbergu[Limberg flap reconstruction for pilonidal sinus]. Khirurgiia (Mosk).2021;(11):34-38. Russian. doi: 10.17116/hirurgia202111134
6. Giuseppe F, Silvia DG, Patrizia R, et al. Pilonidal sinus disease:preliminary case-control study on heat-related wound dehiscence.Ann Med Surg. 2019;48:144-149. doi: 10.1016/j.amsu.2019.07.032
7. Bi S, Sun K, Chen S, Gu J. Surgical procedures in the pilonidalsinus disease: a systematic review and network meta-analysis. SciRep. 2020;10(1):13720. doi: 10.1038/s41598-020-70641-7
8. Collings AT, Rymeski B. Updates on the management ofpilonidal disease. Adv Pediatr. 2022;69(1):231-241. doi:10.1016/j.yapd.2022.03.001
9. Gozukucuk A, Cakiroglu B, Yapici S, Cesur IB, Ozcelik Z, KilicHH. Comparing crystallized phenol and surgical excisiontreatments in pilonidal sinus disease. J Coll Physicians Surg Pak.2022;32(5):652-657. doi: 10.29271/jcpsp.2022.05.652
10. Lund J, Tou S, Doleman B, Williams JP. Fibrin glue for pilonidalsinus disease. Cochrane Database Syst Rev. 2017;1(1):CD011923.doi: 10.1002/14651858.CD011923.pub2
11. Williams MD, Sullivan GA, Nimmagadda N, et al. Laser ablationof pilonidal sinus disease: a pilot study. Dis Colon Rectum.2023;66(5):e224-e227. doi: 10.1097/DCR.0000000000002745
12. Halleran DR, Onwuka AJ, Lawrence AE, Fischer BC, Deans KJ,Minneci PC. Laser hair depilation in the treatment of pilonidaldisease: a systematic review. Surg Infect. 2018;19(6):566-572. doi:10.1089/sur.2018.099
13. Bi S, Sun K, Chen S, Gu J. Surgical procedures in the pilonidalsinus disease: a systematic review and network meta-analysis. SciRep. 2020;10(1):13720. doi: 10.1038/s41598-020-70641-7
14. Can MF, Sevinc MM, Hancerliogullari O, Yilmaz M, Yagci G.Multicenter prospective randomized trial comparing modifiedLimberg flap transposition and Karydakis flap reconstructionin patients with sacrococcygeal pilonidal disease. Am J Surg.2010;200(3):318-327. doi: 10.1016/j.amjsurg.2009.08.042
15. Sewefy AM, Hassanen A, Atyia AM, Saleh SK. Karydakis flapwith compressing tie-over interrupted sutures without drainversus standard Karydakis for treatment of sacrococcygealpilonidal sinus disease. Dis Colon Rectum. 2017;60(5):514-520.doi: 10.1097/DCR.0000000000000784
16. Sahin A, Simsek G, Arslan K. Unroofing curettage versusmodified Limberg flap in pilonidal disease: a retrospective cohortstudy. Dis Colon Rectum. 2022;65(10):1241-1250. doi: 10.1097/DCR.0000000000002227
17. Gavriilidis P, Bota E. Limberg flap versus Karydakis flap fortreating pilonidal sinus disease: a systematic review and meta-analysis. Can J Surg. 2019;62(2):131-138. doi: 10.1503/cjs.003018
18. Boshnaq M, Phan YC, Martini I, Harilingam M, Akhtar M,Tsavellas G. Limberg flap in management of pilonidal sinusdisease: systematic review and a local experience. Acta Chir Belg.2018;118(2):78-84. doi: 10.1080/00015458.2018.1430218
19. Destek S, Bektaşoğlu HK, Kunduz E, Akyüz MN. Comparison ofpostoperative quality of life of Limberg flap and Karydakis flapin pilonidal sinus operations. Turk J Surg. 2020;36(1):59-64. doi:10.5578/turkjsurg.4598
20. Alvandipour M, Zamani MS, Ghorbani M, Charati JY, KaramiMY. Comparison of Limberg flap and Karydakis flap surgeryfor the treatment of patients with pilonidal sinus disease: asingle-blinded parallel randomized study. Ann Coloproctol.2019;35(6):313-318. doi: 10.3393/ac.2018.09.27
Article available in :
Volume 4, Issue 6, 2023
Page : 694-698
https://doi.org/10.47582/jompac.1390623
Article Information
Received : 16 Kas 2023
Accepted : 26 Ara 2023
Published : 31 Ara 2023
Corresponding Author :

Burak Uçaner: Department of General Surgery, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey

[email protected]
Citation : Uçaner B, Çimen Ş, Buldanlı MZ. Evaluation of single center clinical experience in patients undergoing modified Limberg flap technique in pilonidal sinus disease. J Med Palliat Care. 2023;4(6):694-698.

Read: 16
Cited: 0
Download : 51
_Footer