Comparison between Karydakis flap repair and Limberg flap for surgical treatment of sacrococcygeal pilonidal sinus (short term results)

Abstract

Purpose: Pilonidal sinus is an intergluteal region disease with acute or chronic pain and is especially more common in young men. There are many medical modalities and surgical techniques in the treatment of this disease. At this study we aimed to present two different types of surgical methods and their follow-up results in patients with pilonidal sinus.

Patients and Methods: Patients with pilonidal sinus disease were treated by excision plus primary closure (Group 1, n=68) or rhomboid excision plus Limberg flap advancement (Group 2, n=74). Data were collected retrospectively and demographic data, operation time, hospital stay duration, time-off from work, follow-up time, number of patients with recurrence and time to recurrence were evaluated in all patients.

Results: No significant difference was detected between group 1 and 2 in terms of gender and duration of operation time (p=0.651). Hospital stay duration (1.44 [1–3] days, p<0.001) and time off from work (12 [8–14] days, p<0.001) were found to be shorter in rhomboid excision with Limberg flap advancement (Group 2). Serous fluid collection and discharge were seen at the site of the lesion in four patients (5.81%) in group 1 (n=68), and in four patients (5.4%) in group 2 (n=74). Subcutaneous hematoma was detected in one patient (1.35 %) in group 2. During the follow-up period, none of the patients developed wound infection. Recurrence was seen in one patient (1.5%) in group 1.

Conclusion: Limberg flap closure method is better and more effective than Karydakis flap in pilonidal sinus disease, because of wound infection control at early stage and less recurrence rate at later stage and early return to daily life.