title: Comparison of Limberg flap and tension-free primary closure during pilonidal sinus surgery.
abstract: BACKGROUND
  Pilonidal disease is an inflammatory disease seen in the intergluteal region. In this study, our aim was to compare the efficacy of the Limberg flap versus a tension-free primary closure.
  
  
  METHODS
  A total of 93 patients were included in this study. The patients were assigned consecutively by the closed-envelope technique to one of two groups: 49 patients in group 1 (excision and Limberg flap) and 44 patients in group 2 (tension-free primary closure). Excision and reconstruction with the Limberg flap was performed in its classic form. For tension-free primary closure after excision of the sinus tract with an elliptical incision, the skin and subcutaneous tissue were released 2-3 cm away from the incision line. The subcutaneous tissue was closed twofold with 2/0 polyglactin sutures. The skin underwent 3/0 polypropylene mattress suturing.
  
  
  RESULTS
  The median age was 25 years (17-43 years). The median follow-up period was 29.5 months (8-43 months). There was no significant difference between the groups in terms of age, sex, follow-up time, or anesthesia method. One patient in each group experienced wound infection. During the first 6 months of follow-up there was no recurrence. However, at later visits recurrences were seen in two patients in each group (4.1% in group 1, 4.5% in group 2).
  
  
  CONCLUSIONS
  The lower rates of wound infection and recurrence associated with the Limberg flap reported elsewhere may be associated with healing of the tension-free procedure. In this study, tension-free primary closure was found to be as effective as the Limberg flap reconstruction.
authors: Department of General Surgery, Konya Education and Research Hospital, Konya, Turkey.
authors: Ahmet
authors: A
authors: Okuş
authors: Bariş
authors: B
authors: Sevinç
authors: Omer
authors: O
authors: Karahan
authors: Mehmet A
authors: MA
authors: Eryilmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010864:Pilonidal Sinus / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D013524:Surgical Flaps; D013530:Surgical Wound Infection; D013536:Suture Techniques; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D055815:Young Adult