A Retrospective Analysis of the Surgical Treatment Options for Sacrococcygeal Pilonidal Sinus, with Special Reference to Limberg Flap

Abstract

Introduction: Pilonidal sinus (PNS) is a vexing problem for a individual. PNS is blind ending track lined with granulation tissue leading to a cystic cavity containing bits and pieces of hair. Aim: To observe and analyse the surgical treatment options for sacrococcygeal pilonidal sinus with a special reference to limberg flap. Material and Methods: The patients presenting with PNS to the general surgery department at a tertiary care centre in north Malabar, Kerala for two years from 2016 were included in this study. All PNS without abscess formation were treated with limberg flap, Z plasty or wide local excision. Those with abscess formation, I&D was done primarily. Later after the abscess healed, wide local excision and healing with secondary intention was followed. Results: 39 cases of sacrococcygeal PNS were included in this study. Karydakis and Bascom method methods were not used. There was single recurrence each after wide excision and limberg flap and 2 after Z plasty in sacrococcygeal pilonidal sinus. Conclusion: Sacrococcygeal pilonidal sinus is a vexing problem. The changes in the hormonal balance during puberty is the triggering factor. Many treatment modalities are in the offering, suggesting that a complete cure may not be possible with any of those available. Wide local excision with primary closure with Limberg flap or Z plasty or wide local exciion with healing by secondary intention are viable options for this condition.