Faisal Shabbir, Mahmood Ayyaz, Muhammad Waris Farooka, Hassan Sarwar, Awais Amjad Malik, Asad Ali Toor.
Modified Limberg's flap versus primary closure for treatment of pilonidal sinus disease: A comparative study.
J Pak Med Assoc Jan ;64(11):1270-3.

Objectives: To compare the outcome of Rhomboid excision and Modified Limberg`s flap closure with excision and primary closure for the treatment of Sacrococcygeal Pilonidal sinus. Methods: The study was conducted at the Surgical Department of Mayo Hospital, Lahore, from 2009 to 2012. A total of 60 patients of pilonidal sinus were randomly divided into two equal groups. The patients were operated under general anaesthesia in prone position by Rhomboid excision and Modified Limberg`s flap closure with a closed suction drain in group 1, and excision and primary closure over a drain in group 2. Patients were followed up for 12 months for surgical complications of the treatment. SPSS 17 was used for statistical analysis. Results: In group 1 there were 27(90%) males and 3(10%) females, while group 2 had 28(93.3%) males and 2(6.7%) females. The infection rates were observed to be 2(7%) in group 1 and 8(26.6%) (p<0.038) in group 2. The recurrence rate was only 1(3.3%) in group1 compared to 4(13.3%) in group 2. Average hospital stay was 1.63±0.67 days group 1 and 2.8±1.24 days in group 2. Conclusion: Modified Limberg's flap closure is an effective treatment modality for pilonidal sinus disease with 1.5 times less infection rate, 4 times less recurrence rate and 40% in-hospital time.

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