Limberg flap procedure for pilonidal sinus disease: results of 353 patients.
OBJECTIVE
Pilonidal sinus disease is common especially in young adult males. Many surgical and nonsurgical methods have been described. Some surgical techniques for the treatment still have high recurrence rate. The aim of this study was to evaluate advantages and long term results of Limberg flap surgical technique.


METHODS
From November 2001 to December 2004, 353 patients [335 male, 18 female; average age = 24.65 +/- 4.2 (range, 15-53) years] with primary or recurrent pilonidal sinus disease were operated on under spinal anesthesia by rhomboid excision and Limberg flap. Follow-up examinations were made at the end of the 4 weeks and 3, 6, 12, 18, and 24 months after surgery.


RESULTS
The mean duration of symptoms was 23.28 +/- 16.09 (range, 2-140) months. The mean duration of hospital stay was 4.51 +/- 2.85 (range, 2-19) days. Thirty nine patients (11%) had recurrent disease. Total wound dehiscence and flap necrosis did not occur in any patient. Recurrences were observed in 11 patients (3.1%) at the end of the follow up period.


CONCLUSIONS
Quick healing time, short hospital stay, early return to daily life, low complication and recurrence rate are the important advantages of the Limberg flap procedure. We think using closed suction drain in Limberg flap operation is not necessary. In the light of this study results, Limberg flap surgical technique may be an ideal operation for pilonidal sinus disease.
Mentes
Oner
O
Department of General Surgery, Etimesgut Military Hospital, Etimesgut, Ankara, Turkey. onermentes@yahoo.com
Bagci
Mahir
M
Bilgin
Turker
T
Ozgul
Omer
O
Ozdemir
Mustafa
M
D000293:Adolescent; D000328:Adult; D000775:Anesthesia, Spinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010864:Pilonidal Sinus / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D013396:Suction; D013524:Surgical Flaps; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult