title: Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease.
abstract: OBJECTIVE
  Sacrococcygeal pilonidal sinus is common in young men and may recur over time after surgery. We investigated whether a factor exists that can aid in the determination of the preferred technique between the early Limberg flap and Karydakis flap techniques for treating recurrent pilonidal sinus.
  
  
  METHODS
  This prospective and randomized study enrolled 71 patients with recurrent pilonidal sinus in whom the Limberg flap or Karydakis flap techniques were applied for reconstruction after excision. Patients were divided into two groups as follows: 37 patients were treated with the Limberg flap technique and 34 patients were treated with the Karydakis flap technique. Fluid collection, wound infection, flap edema, hematoma, partial wound separation, return to daily activities, pain score, complete healing time, painless seating and patient satisfaction were compared between the groups. ClinicalTrial.gov: NCT02287935.
  
  
  RESULTS
  The development rates of total fluid collection, wound infection, flap edema, hematoma, and partial wound separation were 9.8%, 16%, 7%, 15% and 4.2%, respectively; total flap necrosis was not observed in any patient (p<0.001). During the average follow-up of 28 months, no patients (0%) developed recurrent disease. The two groups differed with respect to early surgical complications (p<0.001).
  
  
  CONCLUSIONS
  In this study, use of the Limberg flap was associated with lower complication rates, shorter length of hospital stay, early return to work, low pain score, high patient satisfaction and better complete healing duration. Therefore, we recommend the Limberg flap for treatment of recurrent pilonidal sinus.
authors.affiliation: Department of General Surgery, Namık Kemal University, Tekirdağ, Turkey.
authors.forename: İlhan
authors.initials: İ
authors.lastname: Bali
authors.affiliation: Kars State Hospital General Surgery, Kars, Merkez, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aziret
authors.affiliation: Department of General Surgery, Namık Kemal University, Tekirdağ, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Sözen
authors.affiliation: Department of General Surgery, Namık Kemal University, Tekirdağ, Turkey.
authors.forename: Seyfi
authors.initials: S
authors.lastname: Emir
authors.affiliation: Department of General Surgery, Adana Training and Research Hospital, Adana, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Erdem
authors.affiliation: Department of General Surgery, Adana Training and Research Hospital, Adana, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Çetinkünar
authors.affiliation: Kars State Hospital General Surgery, Kars, Merkez, Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: İrkörücü
mesh_terms: D000293:Adolescent; D000328:Adult; D062109:Dermatologic Surgical Procedures; D004487:Edema / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008488:Medical Illustration; D061646:Operative Time; D017060:Patient Satisfaction; D010781:Photography; D010864:Pilonidal Sinus / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult