title: [Pilonidal sinus: Secondary wound closure vs. Limberg flap : Cost and satisfaction analysis].
abstract: BACKGROUND
  After excision of a pilonidal sinus, several treatment options are possible, but no gold standard has been established. A literature review revealed no study comparing the costs and time off work after either secondary wound closure or treatment with a Limberg transposition flap. The aim of this study was to focus on these aspects by analysing the patients treated at the KlinikumStadtSoest.
  
  
  METHODS
  Sixty patients with pilonidal sinus after excision were treated either by secondary wound closure or Limberg transposition flap at the KlinikumStadtSoest between 2011 and 2012. The authors analysed retrospectively the patients' demographics, cost, and satisfaction with both techniques and compared them.
  
  
  RESULTS
  For secondary wound closure (group 1) 19 out of 31 patients and for Limberg transposition flap (group 2) 21 out of 29 met the inclusion criteria. Time off work following the final surgery (group 1: 69 day vs. group 2: 30 days, p = 0.046) and the number of dressing changes (group 1: 107 times vs. group 2: 16 times, p = 0.000) were significantly lower in the group of Limberg transposition flap (group 2) as well as the associated costs. The surgery-related costs were lower when treated by secondary wound closure.
  
  
  CONCLUSIONS
  Plastic reconstruction with Limberg transposition flap (group 2) provides a chance to reduce the period of incapacity for work due to a shorter treatment period. With that said, patients should nonetheless be offered both techniques as the current literature does not reveal a clear benefit for either procedure.
authors.affiliation: Klinische Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Medizinische Universität Graz, Graz, Österreich. patricia.lebo@medunigraz.at.
authors.forename: P B
authors.initials: PB
authors.lastname: Lebo
authors.affiliation: Klinik für Plastische, Hand- und Wiederherstellungschirurgie, KlinikumStadtSoest, Senator-Schwartz-Ring 8, 59494, Soest, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Dahmann
authors.affiliation: Universität Wien, Universitätsring 1, 1010, Wien, Österreich.
authors.forename: E
authors.initials: E
authors.lastname: Sinkovits
authors.affiliation: Klinik für Plastische, Hand- und Wiederherstellungschirurgie, KlinikumStadtSoest, Senator-Schwartz-Ring 8, 59494, Soest, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Meyer-Marcotty
mesh_terms: D000041:Absenteeism; D000328:Adult; D003365:Costs and Cost Analysis; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000191:economics*; D010864:Pilonidal Sinus / Q000191:economics* / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000191:economics* / Q000637:transplantation*; D013536:Suture Techniques / Q000191:economics*
keywords: Cost analysis; Pilonidal sinus; Plastic surgery; Surgical flap; Wound healing