Comparison of surgical Limberg flap technique and crystallized phenol application in the treatment of pilonidal sinus disease: a retrospective study

Abstract

Objective: This study was designed to compare the efficacy of crystallized phenol method with Limberg flap in pilonidal sinus treatment. Material and Methods:Patients with a diagnosis of pilonidal sinus disease treated with surgical excision + Limberg rhomboid flap technique and crystallized phenol method between 2010-2011 in the Şevket Yılmaz Training and Research Hospital, Department of General Surgery were evaluated retrospectively. Patients' age, sex, length of hospital stay, complications and recurrence rates were evaluated.Results: Eighty eight percent of patients were male and mean age was 26.84±6.41 in the Limberg group, and 24.72±5.00 in the crystallized phenol group. Sinus orifice locations and nature, and duration of symptoms before surgery were similar in the two groups. Length of hospital stay in the Limberg group was 1.46±0.61 days; whereas all patients in the crystallized phenol group were discharged on the same day. Infection, hematoma, wound dehiscence, and cosmetic problems were significantly higher in the Limberg group. There was no difference between the two groups in terms of recurrence and seroma formation. Conclusion:The less invasive method of crystallized phenol application may be an alternative approach to rhomboid excision and Limberg flap in patients with non-complicated pilonidal sinus disease, yielding acceptable recurrence rates.

Treatment of pilonidal disease by phenol application

“…It offers a good quality of life and satisfaction to patients (17,23). The rate of cosmetic problems is high with surgical methods (18). Phenol application does not change the anatomic structure of the affected area.…”

“…There are techniques that adjust the amount of phenol based on sinus volume measurements (14,16,31). The amount of phenol in the application is usually determined by injecting a certain amount of phenol solution into the sinus and then by checking the overflow from the other sinus orifice (1,18,30). Extra attention must be paid to prevent leakage of the excess phenol to the skin.…”

“…In some studies, phenol application has been reported to be as successful as surgical treatments for PD (18,22). Treatment of PD with phenol should be accepted as a better choice according to these success rates and benefits.…”

“…The answers to these questions have not been clarified in the literature so far. The concentration of phenol solution used in clinical practice varies between 25-80% (15,18,19,20). In addition, several forms of phenol such as cream-gel, liquid and crystalline form can be applied (14,15,19,21).…”

Crystallized Phenol Treatment in Postoperative Recurrent Pilonidal Disease

“…After surgery a variety of complications can be seen such as wound infection, seroma and wound dehiscence. These complications were observed less with minimally invasive techniques [5]. The recurrence of the disease after surgery is a much more important condition.…”