Superiority of Asymmetric Modified Limberg Flap for Surgical Treatment of Pilonidal Disease

Abstract

The deep intergluteal sulcus and midline gap were slightly flattened over the anococcygeal region. The vacuum effect was decreased, and there were less macerations and fewer infections. Time off from work and discharge time from hospital were shortened by eliminating the moisture effect and reducing complications by lateralizing the lower part of the suture line.

Prospective Analysis of Cosmesis, Morbidity, and Patient Satisfaction Following Limberg Flap for the Treatment of Sacrococcygeal Pilonidal Sinus

“…The low recurrence rate of 1.6% in this study is comparable to the 0% to 5.7% reported in previous randomized trials 11,13 and the 3.1% to 10% reported in large prospective case series, 15,27 although it is accepted that a 12-month follow-up is relatively short because recurrent disease has been reported up to 16 years later. 33 Recurrence rate was not the main scope of this study and was limited to a median of 1.4 years.…”

“…11,12 The Limberg flap has shown very low recurrence rates in many randomized controlled studies, ranging from 0% to 5.7%. 11,13 Furthermore, patient satisfaction and quality of life have been shown to be superior to direct midline closure. 12 In addition, the Limberg flap has been demonstrated to be superior to the Karydakis technique in terms of postoperative wound complications.…”

Secondary Healing versus Midline Closure and Modified Bascom Natal Cleft Lift for Pilonidal Sinus Disease

“…In order to avoid median recurrences and flatten the natal cleft, surgeons have developed numerous procedures such as the Karydakis technique (3,16,17), Bascom procedure (18,19,20,21) and other asymmetrical closing techniques (22,23) such as rhomboid excision with Limberg (24,25,26,27) or Dufourmentel flap closure (28), z-plasty (29) or rotation flap (30). In general, results of these asymmetrical closure and flap techniques seem better than results of open technique or primary midline closure techniques, although the surgical trauma is more extensive, and cosmetic results are not always optimal.…”

Operación de Karydakis ambulatoria en el manejo de la enfermedad pilonidal sacrococcígea

“…Los casos de dehiscencia parcial que hemos observado ocurren precisamente en esa localización, por lo que se ha recomendado que la resección adopte una posición ligeramente "oblicua" 21 . Este hecho parece ser tan relevante que, para prevenir las fallas de las técnicas de rotación de colgajo, recientemente se ha propuesto la resección asimé-trica modificada de la plastía de Limberg 24,25 , que desplaza lateralmente el extremo distal del colgajo.…”