Limberg Flap for Sacrococcygeal Pilonidal Sinus a Safe and Sound Procedure

Aithal, Srikanth K; Rajan, C. S.; Reddy, Narender P.

doi:10.1007/s12262-012-0489-5

Cited by 26 publications

(21 citation statements)

References 15 publications

(16 reference statements)

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“…Data on recurrence and follow-up times pertaining to 12,384 patients treated for PSD by Limberg and Dufourmentel flaps were extracted from 139 additional non-RCTs 4 , 60 , 103 , 104 , 115 , 126 – 128 , 133 , 156 , 157 , 196 , 199 , 201 , 208 , 221 , 224 , 242 , 261 , 262 , 267 , 289 , 302 , 303 , 313 , 318 , 321 , 322 , 334 – 336 , 348 , 372 , 399 , 407 , 410 , 415 , 417 , 426 , 433 , 438 , 439 , 444 – 541 . Among these patients, a recurrence of 0.4% (95% CI 0.3–0.5%) was observed in patients at 12 months, 1.6% (95% CI 1.3–1.9%) at 24 months, 5.2% (95% CI 4.5–5.8%) at 60 months, and 11.4% (95% CI 9.2–13.7%) at 120 months (Fig.…”

Section: Resultsmentioning

confidence: 99%

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Stauffer

Luedi

Kauf

et al. 2018

Sci Rep

203

191

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We systematically searched available databases. We reviewed 6,143 studies published from 1833 to 2017. Reports in English, French, German, Italian, and Spanish were considered, as were publications in other languages if definitive treatment and recurrence at specific follow-up times were described in an English abstract. We assessed data in the manner of a meta-analysis of RCTs; further we assessed non-RCTs in the manner of a merged data analysis. In the RCT analysis including 11,730 patients, Limberg & Dufourmentel operations were associated with low recurrence of 0.6% (95%CI 0.3–0.9%) 12 months and 1.8% (95%CI 1.1–2.4%) respectively 24 months postoperatively. Analysing 89,583 patients from RCTs and non-RCTs, the Karydakis & Bascom approaches were associated with recurrence of only 0.2% (95%CI 0.1–0.3%) 12 months and 0.6% (95%CI 0.5–0.8%) 24 months postoperatively. Primary midline closure exhibited long-term recurrence up to 67.9% (95%CI 53.3–82.4%) 240 months post-surgery. For most procedures, only a few RCTs without long term follow up data exist, but substitute data from numerous non-RCTs are available. Recurrence in PSD is highly dependent on surgical procedure and by follow-up time; both must be considered when drawing conclusions regarding the efficacy of a procedure.

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Section: Resultsmentioning

confidence: 99%

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Stauffer

Luedi

Kauf

et al. 2018

Sci Rep

203

191

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“…The rate of development of flap necrosis after LF is 0 to 3.3% of cases. 1,[12][13][14] Unalp et al 15 reported progressive ischemia and necrosis in only 1 patient (1.5%) who was treated with secondary healing following debridement of the necrotic tissue in their series of 66 patients. In contrast, Topgül et al 13 reported a partial necrosis rate of 3% (6 patients) with the development of necrosis in the upper part (at the end of the upper flap) in their series of 200 patients.…”

Section: Discussionmentioning

confidence: 99%

“…The reported rates of recurrence following LF vary between 0 and 9%. 1,4,[12][13][14][15][16][18][19][20][21][22]24,26,27,30,31 Two other long-term results-hypoesthesia at the operative site and cosmetic satisfaction-have been reported in only a few studies. Akin et al 27 reported a hypoesthesia rate of 9.04%, whereas Mentes et al 12 reported a rate of 2.2%.…”

Section: Discussionmentioning

confidence: 99%

“…The duration of hospitalization varies from 1.7 to 5.9 days in studies in which LF was performed for PS (excluding studies with a modified LF). 1,2,4,[12][13][14][15][16][18][19][20][21][22][23][24][25][26][27][28][29][30][31] Harwood et al 33 reported a mean hospital stay of 3.5 days in their meta-analysis, with a tendency toward early mobilization and shortened duration of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

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Retrospective Review of Pilonidal Sinus Patients With Early Discharge After Limberg Flap Procedure

Altıntoprak

Gündoğdu

Ergönenç

et al. 2014

International Surgery

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The aim of this study was to evaluate the results of cases with pilonidal sinus (PS) disease that underwent Limberg flap (LF) transposition and to compare the short and long-term results of early discharge cases with those in the literature. A total of 345 patients who underwent rhomboid excision and LF transposition for PS were evaluated retrospectively. No major anesthetic or surgical complications occurred. Partial wound dehiscence, localized flap necrosis, hematoma, wound infection, and seroma rates were determined as 4.0, 2.1, 1.5, 3.3, and 3.7% respectively. All patients other than those with a hematoma or localized necrosis were discharged with a drain in place 24 hours after the operation. The recurrence rate was 3.9% after a mean 33.1-month follow-up (range, 6-72 months). As a result, we found that short and long-term results of patients who underwent LF and were discharged 24 hours after the operation were similar to those in the literature. We suggest that patients without postoperative complications, such as hematoma or flap necrosis, can be discharged early.

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“…Pilonidal disease can be treated with various surgical methods, however, risk of recurrence remains high [9]. Recurrence rate of 20-40% has been reported regardless of the surgical technique [10]. Flap techniques provide a flattened intergluteal sulcus, tension-free repair, less hairy tissue and reduced sweating [9].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2019

Our Dermatol Online

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Background: Pilonidal disease is a common condition that usually affects young men. The disease presents with pain, cysts, abscesses, pits, sinus tracts, retained hairs and draining in the sacrococcygeal area. Various surgical techniques have been described in the treatment of pilonidal disease. Modified Limberg flap is a commonly used procedure, however, studies which compared the outcomes of modified Limberg flap technique have reported different results. Diverse geometric rhomboid excisions in shape and size, and varied lateralization distance can lead to differences in healing time, complication and recurrence rates. Standardization of the modified Limberg flap technique can help to compare the end results of the surgical intervention more accurately. Therefore, we developed an acetate template to draw a sketch map of Limberg/modified Limberg flap preoperatively, in order to standardize the procedure. Materials and Methods: A Limberg/modified Limberg flap template was prepared by using an online drawing program. Rhomboid flaps with four different sizes were drawn. The template was printed onto an acetate sheet. With the help of a sewing needle, pin holes were performed on the acetate template. The borders of the rhomboid excision and the Limberg/modified Limberg flap were defined with the acetate template and drawn on the gluteal region by using a water resistant multipurpose pen. The surgeon decided which rhomboid flap size to choose according to the dispersion of the pilonial sinus openings. All pilonidal pits and abscess orifices stayed within the resected area. The size of modified Limberg flap was standardized by the help of the acetate template. Results: This study included 10 male patients with pilonidal disease between the ages of 20 to 35. The mean disease duration of the patients was 4.2 years. All the patients underwent modified Limberg flap surgery using an acetate template. The follow-up period was three months. We observed surgical site infection only in one patient within seven days, postoperatively. Conclusions: We suggest that using a standardized template while performing a modified Limberg flap procedure for the treatment of pilonidal disease may help to evaluate and compare the outcomes of this surgical procedure more accurately.

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Limberg Flap for Sacrococcygeal Pilonidal Sinus a Safe and Sound Procedure

Cited by 26 publications

References 15 publications

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Retrospective Review of Pilonidal Sinus Patients With Early Discharge After Limberg Flap Procedure

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