title: Open excision with secondary healing versus rhomboid excision with Limberg transposition flap in the management of sacrococcygeal pilonidal disease.
abstract: OBJECTIVE
  To compare the outcome of Open excision and secondary healing with rhomboid excision and Limberg flap in the management of sacrococcygeal pilonidal sinus disease (SPD).
  
  
  METHODS
  A prospective, analytical, comparative study using randomized controlled trial (RCT) was conducted at Liaquat University Hospital (Jamshoro) & Fatima Hospital-Baqai Medical University (Karachi), from June 2004 to July 2007. In total 49 patients, who either underwent open excision and secondary healing (group A: 25 patients) or rhomboid excision and Limberg flap (group B: 24 patients), were enrolled in the study. Duration of operation, postoperative pain, duration of hospital stay, postoperative complications, and time to recurrence were noted. The inclusion criteria were all patients with primary or recurrent SPD. The exclusion criteria were: cases with incomplete data and those lost to follow-up.
  
  
  RESULTS
  Duration of operation was longer in group B patients (p = 0.004) but pain perception was markedly reduced in this group (p = 0.003). Total hospitalization period was shorter in patients in group B (p = 0.002) and so was the time for complete healing of the wound (p = 0.002). The recurrence rate was also significantly lower in patients who underwent Limberg rotation flap (p = 0.005).
  
  
  CONCLUSIONS
  Limberg flap is advantageous over simple excision and secondary healing in the management of SPD.
authors.affiliation: Surgical Unit IV, Liaquat University Hospital, Jamshoro, Pakistan.
authors.forename: Akmal
authors.initials: A
authors.lastname: Jamal
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shamim
authors.forename: Fazila
authors.initials: F
authors.lastname: Hashmi
authors.forename: Muhammad Idrees
authors.initials: MI
authors.lastname: Qureshi
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010149:Postoperative Pain / Q000209:etiology*; D010154:Pakistan / Q000453:epidemiology; D010864:Pilonidal Sinus / Q000453:epidemiology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012445:Sacrococcygeal Region / Q000601:surgery*; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome