Modified Limberg Flap in Pilonidal Sinus: Our Experience

Abstract

Introduction: Pilonidal sinus disease is a chronic disease occurring in young hairy adult males.  Many Surgical procedures have been described in literature to manage Pilonidal sinus disease, the best surgical technique is still debated. Excision of pilonidal sinus with Limberg flap reconstruction is still one of the most commonly performed procedures for this disease because of its low complication and recurrence rate and higher postoperative quality of life. Aim: The aim of our study was to analyse the long-term results of modified Limberg flap reconstruction technique to manage the defect post rhomboid excision of pilonidal sinus. Methods: We conducted a prospective observational study, to study the results of rhomboid excision and modified Limberg transposition flap closure in the management of the Pilonidal sinus. Form September 2016 to September 2022, 27 male patients were treated with modified Limberg flap repair (Mentes modification) under regional anesthesia. Follow-up examinations were made at the end of the 2 weeks and 3, 6, 12, 18, and 24 months after surgery. Results: Average age of Patients was 24 ± 4.2 years with a range of 15-43yrs. Duration of symptoms ranged from 2 months to 36 months with mean of 10 months. Patients usually  presented with local pain, swelling, and/or a  seropurulent discharge . None of our patients developed total wound dehiscence or flap necrosis. One patient  had recurrence at the end of the follow up period. Conclusion: Rhomboid  excision of pilonidal sinus and reconstruction by  Limberg transposition flap is one of the best methods to manage this notorious condition because of  short hospital stay, low recurrence rates, , and earlier return to normal activities.