Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Saccrococygeal Pilonidal sinus is a common surgical condition and its management is still
debatable, as many surgical techniques were developed aiming to improve outcome, better patient
satisfaction, and most importantly to prevent recurrence. Rhomboidal flap procedure "limberg flap"
is very safe and effective method for pilonidal sinus treatment due to its low complication rate
specially recurrence hence in this study we address the role of limberg flap procedure in
management of pilonidal sinus and how its complications are.
OBJECTIVE:
To analyze the outcome of "Limberg" Rhomboidal flap, in managing sacrococcygeal Pilonidal
sinus as a novel, with a potentially less complication and recurrence rate surgical procedure.
PATIENT AND METHOD:
This is a prospective study on 44 patients suffered from sacroccocygeal pilonidal sinus, 36 patients
with primary disease and 8 patients had recurrent or previously managed pilonidal sinus collected
randomly in the 5th floor surgical department in Baghdad teaching hospital from June 1st 2014 to
December 10th 2015. All underwent rhomboidal flap procedure .there was no exclusion criteria,
data collected included demographic distribution, primary or recurrent pilonidal sinus, wound
complications, and recurrence. The minimum follow up period was 1 year after surgery.
RESULTS:
44 patients had undergone this procedure most of them were males (41 patients), and
(3 patients) were females, youngest patient was a 16-year old and oldest one was 41-year old. Mean
agewas26. 1years±5.6SD, 5 patients (11.4%) had a previous formal surgical repair of pilonidal
sinus, 3 patients (6,8%) had a previous drainage of pilonidal abscess. The mean duration of the
disease is 10.9 months±6.9 SD.Our finding revealed that 3(6.8%) patients developed seroma ,
2(4,5%)patients had wound infection that all responded to conservative treatment. Other suspected
complications including flap necrosis, wound dehiscence and hematoma were not reported with any
of our patients.
CONCLUSION:
Rhomboid flap is very safe and effective method for treatment of pilonidal sinus disease due to its
low complication rates especially recurrence of pilonidal disease, it also offers a good patient
satisfaction, although this procedure takes a longer operating time than the classical methods but it
is easy to be learned and practiced with efficiency .