Mahboob Alam, Nasim Afzal Tarar, Bilal Afzal Tarar, Mahmood Alam.
Study for Treatment of Sacrococcygeal Pilonidal Sinus with Simple Excision versus Limberg Flap.
Pak J Med Health Sci Jan ;12(3):911-3.

Background: Pilonidal sinus is common in various professions and cumbersome for day to day working. Recurrence after the treatment is commonly noted in various treatment modalities. Therefore various methods for treatment are being practiced for the management of this ailment. In view of this, recent addition of rhomboid excision and Limberg flap repair as feasible procedure for treatment of pilonidal sinus disease is a good option. Therefore, our aim is to evaluate the role of rhomboid excision of the pilonidal sinus with Limberg flap by comparing this procedure with the traditional excision and secondary healing. Methods: This prospective study recruited 30 patients with sacrococcygeal pilonidal sinus. The patients were randomly divided into two equal groups. Rhomboid excision of the sinus with Limberg flap was performed in 15 patients (group A) and excision of the sinus with secondary healing was offered to other 15 cases (group B). Demographic data and surgical outcome were compared between both groups. Results: Group A showed significant early return to work and significant less postoperative pain than group B. Similarly, incidence of wound dehiscence, postoperative hematoma, seroma and post-operative infection was less among group A. Wound healing with group B patients with open wound takes long time to heal with lot of discomfort for the patient even for many days. Conclusion: Rhomboid excision and Limberg flap repair is an advantageous and effective modality than simple excision with secondary healing in treatment of sacrococcygeal disease. In addition, it is safe and easy procedure; it may prove to be an ideal treatment option in management of pilonidal sinus today and in the days to come.

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