Comparison of postoperative quality of life of Limberg flap and Karydakis flap in pilonidal sinus operations

Abstract

Objective: Pilonidal sinus disease (PSD), most commonly seen in young men, is a chronic disease resulting from the pilosebaceous in the sacrococcygeal region. There is still no standardization in surgical treatment. In this study, the effectiveness, follow up outcomes and quality of life level were compared between Karydakis flap (KF) and Limberg flap (LF) operations. Material and Methods:Among the patients who had undergone PSD surgery in our clinic between 2015 and 2016, those who could be reached and who received KF (n= 53) and LF (n= 51) operations were included into the study. Clinical data of these patients were retrospectively evaluated. Postoperative satisfaction levels of the patients were determined with Cardiff wound healing survey questions and visual analog scale.Results: Mean operational time was 54 (44-75) minutes in the LF group and 45 (35-60) minutes in the KF group, and it was statistically significant (p= 0.001). Mean time to return to work was 14.3 (9-28) days in the LF group and 17.6 (10-30) days in the CF group and was statistically significant (p= 0.001). The rates of complications and recurrence were lower in the LF group although the difference was not statistically significant between the groups (p> 0.05). Mean psychosocial assessment score was 70.3 (57.5-88.7) in the KF group and 73.4 (53.5-87.5) in the LF group and the difference was statistically significant (p= 0.001). Conclusion:LF was a more reliable and preferable method compared to KF because of earlier return-to-work, lower rate of recurrence at long term follow up, and higher psychosocial satisfaction.

Comparative Study between Excision of Pilonidal Sinus Via Lay Open Technique Versus Closed Technique and between Karydakis Technique Versus Limberg Technique: Meta Analysis

“…3b-As regard Hematoma, 4 studies [14,16,21,25] showing the occurrence of hematoma in both groups with insignificant differences in Limberg technique (4.819%) vs Karydakis technique (1.93%) p-value 0.8236, I 2 (inconsistency) 0.0%, 95% CI for I 2 0.00-82.71.…”

“…1-Operative time/min showed that 11 studies [5,13,14,16,18,20,[22][23][24][25][26] showing the mean Operative time/min in both groups with significant higher in Limberg technique (48.17 ±8.8) vs Karydakis technique (39.19±8.34) p-value <0.0001, I 2 (inconsistency) 92.54%, 95% CI for I 2 88.60-95.11.…”

“…5-As regard Recurrence, 14 studies [5,[13][14][15][16][17][18][20][21][22][23][24][25][26] showing that a total of 86 cases recomplain from pilonidal sinus in both groups, 31 cases after karydakis technique and the other 55 cases after limberg technique with insignificant difference in Karydakis technique (3.09%) vs Limberg technique (4.89%) p-value 0.9247, I 2 (inconsistency) 0.0%, 95% CI for I 2 0.00-10.89.…”

“…14): Meta-analysis for hospital stay/day. CI : Confidence interval (LL: Lower limit -UL: Upper Limit).…”

Comparison of Primary Simple Closure and Limberg Flap Technique in Pilonidal Sinus

“…Males are twice more affected as females and the incidence of the disease is reported as 26 per 100,000 population [2]. Several surgical interventions are described in the literature despite conservative management, but the problem of treatment failure and disease recurrence is quite significant, which leads to morbidity in these otherwise healthy patients and hence interventions have variable success rates [3,4]. As compared to simple excision, primary closure is the preferred technique as it is associated with a lower risk of postoperative infection and wound dehiscence, rapid healing by primary intention, and less number of postoperative visits, less pain, and earlier hospital discharge, and social mobility [5].…”