Treatment of adolescent pilonidal disease with a new modification to the Limberg flap: Symmetrically rotated rhomboid excision and lateralization of the Limberg flap technique

Afşarlar, Çağatay Evrim; Yılmaz, Engin; Karaman, Ayşe; Karaman, Íbrahím; Özgüner, İsmet Faruk; Erdoğan, Derya; Çavuşoğlu, Yusuf Hakan; Maden, Haşim Ata

doi:10.1016/j.jpedsurg.2013.01.029

Cited by 33 publications

(29 citation statements)

References 25 publications

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“…Among these reasons, there is debate about whether obesity is an important factor in the formation of pilonidal sinus disease [13][14][15]. In this retrospective study, 47.8% of patients had a BMI of 25 or greater.…”

Section: Discussionmentioning

confidence: 85%

Surgical treatment with rhomboid excision and Limberg flap technique under spinal anesthesia of 23 young with pilonidal sinus disease

Öztürk

Yoldaş²,

Karagöz³

2018

j-ebr

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A B S T R A C T Aim:To present the experience of treatment with Limberg flap procedure under spinal anesthesia in 23 young patients with pilonidal sinus disease. Methods: This was a retrospective study of 23 young patients who underwent surgery for pilonidal sinus disease under spinal anesthesia between January 2011 and November 2017 in the Division of Pediatric Surgery. All patients were evaluated for age, sex, clinical diagnosis, and body mass index, and infection, duration of symptoms, treatment, healing time, recurrences, complications and results. Results: Of the 23 patients, 4 (17%) were male, and 19 (83%) were female. The mean age of the patients was 15.21 ± 2.8 years and the mean symptom duration was 4 ± 2.6 months. In 13 patients (56.5%), there was one or more sagittal lines in the midline and the mean sinus number of the patients was 2.12 ± 0.60. Pain was the most important complaint affecting the quality of life of the patient. The mean body mass index was 26.33 ± 2.54 kg / m2, and 47.8% (n = 11) were high BMI and 53.2% were normal BMI. One patient had temporary headache and one patient had urinary retention. Wound infection occurred in 2 patients (8.6%). Recurrence was not observed in patients. Conclusion: In this study, pilonidal sinus disease was treated with Limberg flap procedure under spinal anesthesia. The combination of these two applications in patients with pilonidal sinus may provide significant advantages, such as rapid recovery and short hospital stay, early return to daily activities, low complications, and recurrence rates.

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Section: Discussionmentioning

confidence: 85%

Surgical treatment with rhomboid excision and Limberg flap technique under spinal anesthesia of 23 young with pilonidal sinus disease

Öztürk

Yoldaş²,

Karagöz³

2018

j-ebr

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“…(Table ). Moreover, there is some evidence supporting the use of the Dufoumentel rhomboid flap over the Limberg flap, with advantages such as flexibility, simplicity of reconstruction, repeatability and good outcomes in terms of the recurrence rate being reported …”

Section: Discussionmentioning

confidence: 99%

Dufourmentel rhomboid flap in the radical treatment of extensive, complex or recurrent sacrococcygeal pilonidal disease: Case series with follow up

Manterola

Otzen

2018

Surgical Practice

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Aim: Sacrococcygeal pilonidal disease (SPD) is a chronic and uncommon entity. Extensive, complex and recurrent SPD is less frequent, and diverse treatment alternatives have been described. One of these is excision, followed by reconstruction with the rhomboid flap, as described by Dufourmentel. The aim of the present study was to report the results of a series of patients with extensive, complex or recurrent SPD operated on using Dufourmentel's technique, in terms of postoperative morbidity (POM) and recurrence. Patients and Methods: The present study was a case series of patients with extensive, complex or recurrent SPD, operated on at the Clínica Mayor and Regional Hospital in Temuco, Chile, between 2000 and 2015, using excision, followed by a reconstruction with the Dufourmentel's rhomboid flap. The outcome variable was POM measured at 30 days' postoperatively using the Clavien-Dindo classification. Other variables of interest were surgical time, hospital stay, mortality and recurrence. The minimum follow-up time was 18 months. Descriptive statistics were used. Results: Ninety-five patients with extensive, complex or recurrent SPD were operated on in the study period. The median age was 21 years, and 56.8 per cent were female. The median surgical time was 60 min (45-90 min). POM was 13.7 per cent, seroma was 5.3 per cent, wound infection was 2.1 per cent and partial surgical wound dehiscence was 6.3 per cent. Mortality of the series was nil. Median hospital stay, follow up and recurrence were 4 days (3-5), 48 months (18-90 months) and 3.2 per cent, respectively. Conclusion: Dufourmentel's technique applied to patients with extensive, complex or recurrent SPD was associated with adequate postoperative evolution in terms of POM and recurrence.

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“…4 Usually the lowest part of the PD area is located on the midline and this region has to be very carefully excised, so any methods that shift the rhombic excision to the side may be end up leaving some infected tissue behind, leading to a recurrence. 2,14 Reconstruction is not very difficult and enables tension-free closure of the defect with flattening of the natal cleft 2 (Fig. 5).…”

Section: Discussionmentioning

confidence: 99%

“…One modification of this method may be a symmetrically rotated rhomboid excision, especially when the inflamed tissue is located laterally to the midline. 14 In a review of 10,000 patients and 74 studies, Petersen et al found that off-midline closure are superior to midline closure in terms of suture line breakdown and dehiscence (3-5 vs. 9%) and recurrence (1-3 vs. 9.5%). Better results were observed in the Limberg and Dufourmentel group in comparison to the midline-closure group (which the authors of the current study used before the introduction of the DMLF).…”

Section: Discussionmentioning

confidence: 99%

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

Sebastian¹,

Sroczyński²,

Rudnicki³

2017

Adv Clin Exp Med

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Treatment of adolescent pilonidal disease with a new modification to the Limberg flap: Symmetrically rotated rhomboid excision and lateralization of the Limberg flap technique

Cited by 33 publications

References 25 publications

Surgical treatment with rhomboid excision and Limberg flap technique under spinal anesthesia of 23 young with pilonidal sinus disease

Surgical treatment with rhomboid excision and Limberg flap technique under spinal anesthesia of 23 young with pilonidal sinus disease

Dufourmentel rhomboid flap in the radical treatment of extensive, complex or recurrent sacrococcygeal pilonidal disease: Case series with follow up

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

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