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

Abstract

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.

The Dufourmentel modification of the limberg flap: Does it fit all?

“…7 In a study by Altintoprak et al, the rate of dissatisfaction with the cosmetic results of the DMLF was 12.6%. 8 In the present study group two patients (5.4%) were dissatisfied with the cosmetic results of the operation, but the most important factor for all the patients was healing by first intention and a quick return to normal activity (probably especially because the patients were young).…”

Modified Limberg flap versus modified Karydakis flap in pilonidal sinus disease: single surgeon experience

“…9 The mean length of hospital stay in flap procedures varies 2 to 5.5 days and they could be safely performed as day-case surgery. 7,[10][11][12][13] In this study the patients in both of groups did not discharged before removing the drain. We thought that the patients could be discharged after the day of surgery but these operations performed in a rural hospital so the patients socio-economic and hygienic status were low cause of this avoiding the wound infection the patients discharged the day remove of the drain.…”

“…In previous studies postoperative complication rates of the flap techniques has been reported between 4.2% and 22.9%. 7,9,12,14 In this study suction drain was used in all operations, oral antibiotics were administered at postoperative period and movement restrictions were advised to the patients till removing the skin sutures. With these postoperative management, the complication rates of the MLF and MKF groups was 10.5% and 12.2% respectively in present study.…”

Comparación Entre El Colgajo De Limberg Y El Colgajo De Karydakis en El Tratamiento De La Enfermedad Del Seno Pilonidal

“…En este estudio, con un corto período de seguimiento, no hay diferencia estadísticamente significativa en la tasa de recurrencia, de 8,3% para el CL y 12,2% para el CK, valores mayores que los comunicados por la mayoría de los autores chilenos y extranjeros que informan entre 3,9% y 3,2% 11,12,14,15 , aunque una serie informa 14,4% de recurrencia 28 . Ambas téc-nicas cumplen con el objetivo de cerrar sin tensión la herida, pero también es indispensable aplanar la hendidura pilonidal y/o resecar suficiente volumen de tejido para asegurar la remoción de senos o fístulas secundarias, lo que probablemente no se cumplió en todos los casos y ha contribuido a esta tasa de recurrencia.…”

“…El procedimiento de Alexander Limberg, descrito en 1956, incluye una resección en forma de rombo simétrico de la línea media enferma, con sus extremos dispuestos fuera de la línea media y la transposición desde lateral a medial de un colgajo fasciocutáneo tallado en el área glútea que rellena el defecto dejado por la resección en rombo y un cierre inmediato de la zona donante glútea 13 . La recurrencia de la enfermedad con este procedimiento se reporta entre 0% y 3,9% 14,15 . En la literatura hay pocos estudios que comparen el cierre primario libre de tensión postulado por Karydakis y el uso del colgajo romboidal de Limberg y sus resultados son contradictorios.…”