scholarly journals Limberg Flap is a Safe and Effective Procedure for the Surgical Treatment of Pilonidal Sinus in Sacrococcygeal Region

2021 ◽  
Vol 12 (1) ◽  
pp. 6-8
Author(s):  
Md Rashidul Islam ◽  
Abul Bashar Md Abdul Matin ◽  
Sami Ahmad ◽  
Md Armanul Islam ◽  
Shoaeb Imtiaz Alam
Keyword(s):  
Postoperative Pain ◽  
Pilonidal Sinus ◽  
Young Male ◽  
Main Concern ◽  
Limberg Flap ◽  
Suction Drain ◽  
Sacrococcygeal Region ◽  
Flap Procedure ◽  
Secondary Closure

Pilonidal sinus in the sacrococcygeal region is an acquired condition and usually seen in young male adults. Diagnosis is indicated by to see the site and appearance of chronic discharging opening, and identification of midline pit in the natal cleft. The management of the sacrococcygeal pilonidal sinus varies from clipping of hairs with good hygiene of the area, wide excision of the area with primary or secondary closure and newer flap procedures, but none is widely accepted. The main concern for the treatment to the patient is the recurrence. This prospective study has been performed to determine the effectiveness and safety of the Limberg flap procedure for sacrococcygeal pilonidal sinus for new and recurrent cases. Primary end point was rate of recurrence and secondary end points were its complianceand complications such as wound infection, postoperative pain and return to work. A total of 17 patients were operated from March 2012 to June 2016.Both primary and recurrent diseases were included. All patients successfully underwent surgery. Patients complained very minimal postoperative pain. LO were average 2 days. All patients were discharged with negative suction drain in situ. Drains were removed on 7th POD and stitches were removed on 9th to 12th postoperative day. All patients returned to work after 2nd weeks. In our study no recurrence or major complications were found. Limberg flap for sacrococcygeal pilonidal sinus was found very useful and effective in terms of recurrence rate and patients morbidity. J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 6-8

Pilonidal sinus disease: Karydakis flap procedure in our patients

2020 ◽  
Vol 99 (8) ◽  
Keyword(s):  
Wound Healing ◽  
Pilonidal Sinus ◽  
Healing Process ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Limberg Flap ◽  
New Disease ◽  
Sinus Disease ◽  
Flap Procedure

Introduction: Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be a frustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Methods: A total of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in a short-term follow-up period. Disease recurrence was defined as prolonged healing or as a new disease requiring repeated surgery. Results: In December 2019 all 27 patients came for a follow-up visit. The result was a fully lateralized wound without any signs of a new disease in all patients. In May 2020 a follow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. Conclusion: According to the available evidence and guidelines, off-midline procedures – the Karydakis flap, Bascom cleft lift, and Limberg flap procedures – are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in a nicely flattened gluteal crease.

scholarly journals Management of pilonidal sinus disease with Limberg flap: our experience

2020 ◽  
Vol 7 (5) ◽  
pp. 1575
Author(s):  
Mahavir Singh ◽  
Saish Dalal ◽  
Baleshwar . ◽  
Sethu Raman
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Tertiary Care ◽  
Pilonidal Sinus Disease ◽  
Common Disease ◽  
Main Concern ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Minimal Scarring ◽  
Early Return

Background: Pilonidal sinus disease is a common disease of young adults. The management of the sacrococcygeal pilonidal sinus varies from conservative measures to various surgical procedures. The main concern for the treatment to the patient is the recurrence. Although several methods have been described all have been associated with high recurrence rates. This study was carried out to evaluate the advantages, results of rhomboid excision and limberg flap reconstruction in the management of pilonidal sinus disease.Methods: This prospective study was conducted in General Surgery department of a tertiary care centre of Haryana. It includes 29 patients who were treated for pilonidal sinus disease by Limberg flap surgery from January 2015 to January 2019.  Results: All patients were successfully treated with minimal postoperative discomfort. Only two patients developed seroma which was managed conservatively and in two patients there was slight flap tip necrosis which was also managed conservatively. Rest all other patients wound healed nicely with minimal scarring, with very less postoperative pain, with no recurrence so far.Conclusions:Limberg flap is very effective treatment for pilonidal disease. It has many advantages as it is easy to perform and design, and it flattens the natal cleft with large vascularized pedicle, sutured without tension. This in turn maintains good hygiene, reducing the friction, preventing maceration, and avoiding scar in the midline. The technique is easy to perform in quick time, useful in both primary and recurrent diseases, with very low complication and recurrence rate. Other advantages are quick healing time, short hospital stay, and early return to daily life.  

scholarly journals Retrospective Review of Pilonidal Sinus Patients With Early Discharge After Limberg Flap Procedure

2014 ◽  
Vol 99 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Fatih Altintoprak ◽  
Kemal Gundogdu ◽  
Tolga Ergonenc ◽  
Enis Dikicier ◽  
Guner Cakmak ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Wound Dehiscence ◽  
Early Discharge ◽  
Long Term Results ◽  
Limberg Flap ◽  
Flap Necrosis ◽  
Flap Procedure ◽  
Short And Long Term

Abstract The aim of this study was to evaluate the results of cases with pilonidal sinus (PS) disease that underwent Limberg flap (LF) transposition and to compare the short and long-term results of early discharge cases with those in the literature. A total of 345 patients who underwent rhomboid excision and LF transposition for PS were evaluated retrospectively. No major anesthetic or surgical complications occurred. Partial wound dehiscence, localized flap necrosis, hematoma, wound infection, and seroma rates were determined as 4.0, 2.1, 1.5, 3.3, and 3.7% respectively. All patients other than those with a hematoma or localized necrosis were discharged with a drain in place 24 hours after the operation. The recurrence rate was 3.9% after a mean 33.1-month follow-up (range, 6–72 months). As a result, we found that short and long-term results of patients who underwent LF and were discharged 24 hours after the operation were similar to those in the literature. We suggest that patients without postoperative complications, such as hematoma or flap necrosis, can be discharged early.

Is the lateralization distance important in terms in patients undergoing the modified Limberg flap procedure for treatment of pilonidal sinus?

2014 ◽  
Vol 19 (5) ◽  
pp. 309-316 ◽  
Author(s):  
B. R. Karakaş ◽  
A. Aslaner ◽  
U. R. Gündüz ◽  
H. Çalış ◽  
A. N. Öngen ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Limberg Flap ◽  
Flap Procedure ◽  
Modified Limberg Flap

scholarly journals Limberg flap procedure for sacrococcygeal pilonidal sinus: a prospective study

2017 ◽  
Vol 4 (7) ◽  
pp. 2238 ◽  
Author(s):  
Prashant Kumar Singh ◽  
Rohit Kumar Gohil ◽  
Neeraj Saxena
Keyword(s):  
Pilonidal Sinus ◽  
High Recurrence Rate ◽  
Limberg Flap ◽  
Flap Reconstruction ◽  
High Patient Satisfaction ◽  
Reliable Technique ◽  
Average Hospital ◽  
Flap Procedure ◽  
Low Incidence ◽  
A Prospective Study

Background: Sacrococcygeal pilonidal sinus is a common and morbid disease associated with high recurrence rate after surgery.  Many conventional surgical procedures have been described for its management with their merits and demerits. The present study aims to evaluate the efficacy and complications of Limberg flap reconstruction surgery.Methods: 32 consecutive patients underwent Limberg flap reconstruction between January 2015 to November 2016 and were evaluated for various parameters.Results: All patients successfully underwent surgery, with very minimal postoperative pain, average hospital stay for 5 days, returned to work after 19 days, with 2 patients having seroma, 1 having flap necrosis, 1 developed wound infection and no recurrences so far. Patients with complications were managed conservatively.Conclusions: Limberg flap for reconstruction of the defect after excision of recurrent sacrococcygeal pilonidal sinus is an effective and reliable technique, easily performed, with high patient satisfaction, associated with complete cure and low incidence of post-operative complications.

Long-Term Results of Limberg Flap Procedure for Treatment of Pilonidal Sinus

2003 ◽  
Vol 46 (11) ◽  
pp. 1545-1548 ◽  
Author(s):  
Koray Topgül ◽  
Ersin Özdemir ◽  
Kadir Kiliç ◽  
Hakan Gökbayir ◽  
Zafer Ferahköşe
Keyword(s):  
Pilonidal Sinus ◽  
Long Term Results ◽  
Limberg Flap ◽  
Flap Procedure

Limberg flap procedure for pilonidal sinus disease: results of 353 patients

2007 ◽  
Vol 393 (2) ◽  
pp. 185-189 ◽  
Author(s):  
Oner Mentes ◽  
Mahir Bagci ◽  
Turker Bilgin ◽  
Omer Ozgul ◽  
Mustafa Ozdemir
Keyword(s):  
Pilonidal Sinus ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Sinus Disease ◽  
Flap Procedure

scholarly journals Limberg flap as a Primary Treatment for Pilonidal Sinus at Nepal Mediciti Hospital: A Single Unit Experience

2021 ◽  
Vol 2 (2) ◽  
pp. 64-67
Author(s):  
Subodh Ghimire ◽  
Sunil Kumar Sharma Dhakal ◽  
Pranil Rai ◽  
Nirvan Rai
Keyword(s):  
Prone Position ◽  
Pilonidal Sinus ◽  
Single Unit ◽  
Primary Treatment ◽  
Limberg Flap ◽  
Related Complication ◽  
Duration Of Symptoms ◽  
Presenting Symptoms ◽  
Suction Drain ◽  
Minimal Scarring

INTRODUCTION: Pilonidal Sinus is a common condition with estimated incidence of 260 per million population with more male predilection and is often seen in sacrococcygeal area but has also been described in other areas with hair. The Limberg rhomboid flap was designed by Limberg in 1946 for the closure of a sixty degree rhombus shaped defect with a transposition flap. We would like to share our single unit experience of Rhomboid Limberg flap for Pilonidal sinus in our hospital. METHODS: This is an ongoing prospective descriptive study in the Department of General Surgery and Digestive Diseases of Nepal Mediciti Hospital from October 2018. The demographic of the patients, presenting symptoms, duration of symptoms and previous interventions are recorded and the Rhomboid Limberg flap surgery is done under regional or general anesthesia in prone position. The patient is given intravenous antibiotic and is instructed to sleep laterally or in prone position for 24 hours. The dressing is removed and the wound is inspected for flap status in the next morning. The patient is discharged on 1st post-operative day on oral antibiotics for 7 days and is followed on 7th post-operative day for removal of suction drain and alternate sutures in the skin and remaining sutures are removed on 10th post-operative day. RESULTS: We have done 28 cases of Limberg flap for Pilonidal Sinus from October 2018 to December 2020 of which 24 were male patients. None of our patients had flap necrosis. One patient presented with accidental removal of suction drain on 5th postoperative day, however he didn’t develop any wound related complication. One patient had superficial wound dehiscence on 10th post-operative day which healed on its own with dressing. One patient developed seroma from 5th postoperative and was managed with dressing and antibiotics and it healed in 2 weeks. None of our patients have developed recurrence and their wounds have healed satisfactorily with minimal scarring and pain. All the patients were able to resume their regular activities within 21 days. All except 2 patients were satisfied with cosmetic outcome. CONCLUSION: The Limberg flap is ideal treatment for pilonidal sinus with minimal postoperative pain, short hospital stay, few complications, rapid return to normal activities, good cosmesis, and a low recurrence rate with short learning curve for young surgeons. Hence, Limberg flap should be routinely used as primary treatment for pilonidal sinus.  

scholarly journals A comparative study of excision with primary closure versus Limberg flap in pilonidal sinus

2019 ◽  
Vol 6 (12) ◽  
pp. 4282
Author(s):  
Omesh Kumar Meena ◽  
Dheer Singh Kalwaniya ◽  
Satya V. Arya ◽  
Manikandan Kuppuswami ◽  
Jaspreet Singh Bajwa ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Disease ◽  
Operating Time ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Flap Procedure ◽  
Operative Complications ◽  
Post Operative Complications

Background: The term ‘pilonidal sinus’ describes a condition found in the natal cleft overlying the coccyx which is treated by excision.Methods: This study is a prospective study held in Department of general surgery, Safdarjung Hospital, New Delhi from October 2014 to April 2016 on 60 patients out of which 30 were controls (excision with primary closure) and 30 were taken as case (Limberg flap). Post-operative follow up was done till 6 months and complications were noted. The data was tabulated and SPSS version 17 was used for statistics.Results: Pilonidal sinus disease is common in age group 20 years and above and twice more common in males than females. Although operating time in Limberg flap is little more as compared to primary closure but insignificant. The post-operative pain in the long term follow up is less in the Limberg flap procedure, although in the initial post-operative period it is slightly higher as compared to primary closure. In Limberg flap procedure, post-operative complications like stitch line infection, seroma formation, wound dehiscence are low as compared to primary closure. Limberg flap require 2.27±0.52 days hospital stay as compared to 3.57±1.43 days in primary closure due to less post-operative complications. Recurrence rate is 3.33% in Limberg flap as compared to 26.67% in primary closure group.Conclusions: We recommend the Limberg flap method for primary pilonidal disease with low morbidity rates over primary closure.

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