The comparison of marsupialization and Limberg flap in the treatment of pilonidal disease
PDF
Cite
Share
Request
Original Article
VOLUME: 21 ISSUE: 4
P: 184 - 190
November 2005

The comparison of marsupialization and Limberg flap in the treatment of pilonidal disease

Turk J Surg 2005;21(4):184-190
1. SSK Ankara Eğitim Hastanesi, 3. Genel Cerrahi Kliniği, ANKARA
No information available.
No information available
PDF
Cite
Share
Request

Abstract

Purpose: In this study; marsupialization and Limberg flap techniques were compared in the treatment of pilonidal disease. Operations for pilonidal disease are frequently performed in the surgical clinics 1-8 percent of all the operations. Although different techniques were described in the treatment; recently flap rotation procedures seem to be more favourable due to their higher rates of success and lower rates of recurrences. Materials and Methods: From August 2001 to July 2004; 114 patients treated with marsupialisation and 102 patients treated with Limberg flap rotation techniques were enrolled. They were randomized according to the last number of their numeric protocol as being single or double at admission. Additional 35 patients were excluded from the study for various reasons. The patients were compared according to age, surgical technique, wound healing, length of hospital stay and returning time for work, education status and patient satisfaction. Results: In the Limberg flap technique; woud healing time and returning time for work parameters were found to be statistically better( p<0.05). The recurrence rates for Limberg flap (2.12%) and marsupialization (4.8 %) found to be statistically nonsignificant (p=0.308). Flap procedure was more succesful than marsupialization considering antibiotic usage and patient satisfaction (p<0.001). Conclusion: Flap procedure is a superior technique to marsupialization because of rapid wound healing, lower antibiotic need, less time to return to work and higher patient satisfaction.

Keywords:
Pilonidal sinus, Limberg flep, marsupialization

References

1
Patey DH, Scarff RW. Pathology of postnatal pilonidal sinus its bearing on treatment. Lancet, 1946;2:484.
2
Page H. The entry of hair into a pilonidal sinus. Br J Surg, 1969;56:32.
3
Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg, 1992;62:385-9.
4
Nivanyvongs, S. Anorectal disorders. In: Surgery Scıentific Prınciples and Practice Lippicott- Raven 1997. p.1199-1200.
5
Sökücü N, Pilonidal sinüs. İn: Genel Cerrahi İstanbul Tıp Fakültesi Temel ve Klinik Bilimler Ders Kitabı, Anorektal hastalıklar 2002. p.1413-1415.
6
Akıncı OF, Bozer M,Düzgün ŞA.Pilonidal sinüs Tanı ve tedavide doğru ve yanlışlar. Kolon Rektum Hast Dergisi, 1996;188.
7
Bascom J. Pilonidal disease Origin from follicles of hairs and results of follicle removal as treatment . Surg, 1980; 87:567-72.
8
Senepati A, Cripps J, Thomopson MR. Bascom's operation in the day surgical management of symptomatic pilonidal sinus. Br J Surg, 2000; 87, 1067 - 1070.
9
Billingham RP. Anorectal miscellany:Pilonidal disease,anal cancer, Bowen's and Paget's diseases and hidradenitis suppurativa. Prim Care, 1999;26:171-177.
10
Ispiter WH, Prasad J. Pilonidal sinus disease. Aust NZJ Surg, 1995;65:561-63.
11
Çubukcu A,Çubukcu D. Pilonidal sinüs hastalığı. Çağdaş Cerrahi Dergisi, 2002;16:234-8.
12
Sondenaa K,Andersen E,Nesvik I,Soreide JA. Patient characteristics and symptoms in chronic pilonidal sinus disease. 1995;10:39-42.
13
Wexner S,Binderow S. Pilonidal disease, presacral cysts and tumors, and pelvic and perianal pain. In:Zuidema GD, Condon RE Eds.Shackelford's Surgery of AlimenteryTract. 4th Ed WB. Saunders Company Philadelphia. 1996. p. 432-449.
14
Allen – Mersh TG. Pilonidal sinus : finding the right tract for treatment. Br J Surg, 1990;77:123-32.
15
Bree E, Zoetmulster AN. Treatment of malignency arising in pilonidal disease. Ann Surg Onc, 2001;8:60-4.
16
Jensen SL, Harling H. Prognosis after simple incision and drainage for first episode acute pilonidal abcess. Br J Surg, 1998;75:60-61.
17
Khamis HAG, İsam MAS, Khalil Ras et al. Treatment of pilonidal sinus by primary closure with a transposed rhomboid flap compare with deep suturing, a prospective randomized clinical trial. Eur J Surg, 1999; 165: 468 - 472.
18
Taylor SA,Halligan S, Bartram CI. Pilonidal sinus disease : MR imaging distinction from fistula in ano. Radiology 2003 ;226:662-7.
19
Eryılmaz R, Şahin M, Alimoğlu O ve ark. Akut pilonidal apse tedavisinde insizyon ve drenajın, cilt eksizyonu ve küretaj ile karşılaştırılması. Ulusa Travma Dergisi, 2003; 9:120-3.
20
Jensen SL, Harling H. Prognosis after simple insicision and drainage for a first episode acute pilonidal abscess. Br J Surg, 1998;75:60-1.
21
Stansby G, Greatorex R. Phenol treatment of pilonidal sinuses of natal cleft. Br J Surg, 1989;76:729-30.
22
Blumberg NA. Pilonidal sinus treated wıth phenol : an old problem revisited. Surg Rounds, 2001; 24:307-16.
23
Vara Thorbeck R., Mekinassi K., Bercnid S: Phenol treatment of pilonidal sinuses. Zentrabl Chir, 1990;115: 777 - 780.
24
Schneider İH, Thaler K, Kökckerliğn F. Treatment of pilonidal sinuses by phenol injections. İn J Colorectal Dis 1974.9 nd ed.p.200 - 202.
25
Stansby G, Greatorex R. Phenol treatment of pilonidal sinuses of natal cleft. Br J Surg, 1989;76: 729 - 730.
26
Akıncı F, Coşkun A, Uzunköy A. Simple and effective surgical treatment of pilonidal sinus. Dis Colon Rectum, 2000; 43:701-6.
27
Hull TL, Wu J. Pilonidal disease. Surg Clin N Am, 2002; 82:1169-85.
28
Senapati A, Cripps NPJ, Thampson MR. Bascom's operation in the day- surgical management of syptomatic pilonidal sinus. Br J Surg, 2000;87:1067-70.
29
Sondenaa K, Nesvik I, Andersen E et al. Recurrent pilonidal sinus after excision with closed or open treatment: final result of a randomised trial. Eur J Surg, 1996;162:237-40.
30
Sola JA, Rothenberger DA. Chronic pilonidal disease: an asessment of 150 cases. Dis Colon Rectum, 1990;33:758-61.