Open Excision versus Limberg Transposition flap in the Management of sacrococcygeal Pilonidal Disease.

Paudel SR, Shrestha S , Chapagain A, Shrestha D, Gurung NV, Upadhyay PK, Gurung A,


Introduction: To compare the outcome of Open excision and Limberg transposition flap in the management of sacrococcygeal pilonidal sinus disease (SPD).

Methods: A prospective, analytical, comparative study using randomized controlled trial (RCT) was conducted in western regional hospital, from June 2011 to June 2014. In total 36 patients were enrolled in the study, 5 were excluded who had pilonidal sinus with abscess and managed with incision and drainage. Out of 31 patients who had pilonidal sinus, open excision (group A: 16 patients) and Limberg flap (group B: 15 patients). Postoperative pain, duration of hospital stay, healing time, wound infection, and recurrence were noted. The inclusion criteria were all patients with primary or recurrent SPD. The exclusion criteria was pilonidal sinus with abcesses .

Results: Out of 31 patients, 27 were males and 4 were females. 16 patients were enrolled in group A and 15 patients in group B. Pain perception was markedly reduced in group B (p<0.05). Mean duration of hospital stay was shorter in patients in group B ( 4.43 vs 2.53 days ) and the time for complete healing of the wound was shorter in group B (p<0.05, 45.12 vs 11.93 days). wound infection and recurrence rate were also significantly lower in patients who underwent Limberg rotation flap (p<0.05, 4 vs 1 ; 2 vs 0).

ConclusIon: Because of less pain perception, shorter hospital stay, earlier healing of wound and lower rates of infection and recurrence, limberg flap was found to be better than open procedure in the management of SPD

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