Comparison of Limberg Flep and Adipofacial Flep in the Surgical Treatment of Pilonidal Sinus: A Prospective Randomized Clinical Study

Abstract

Objective: Pilonidal Sinus Disease (PSD) encompasses inflammation localized to the intergluteal cleft, ranging from minor cyst to extensive sinus formation. The most important parameters in the treatment of the disease are early return to work, low recurrence rate, low postoperative pain, high comfort, low complication rate and low cost. In the surgical treatment of pilonidal sinus disease, there are methods such as flap methods, primary closure and unroofing and curettage. Methods: This study was planned as a prospective randomized clinical trial. Patients were operated with the diagnosis of chronic pilonidal sinus in the surgical clinic of our hospital between 2006-2008. A total of 104 chronic pilonidal sinus patients were randomized into two groups. The first group included 49 patients whom underwent Limberg flap procedure. The second group included 55 patients whom underwent adipofascial flap procedure. The two groups were compared in terms of demographic characteristics, duration of surgery, early and late complications, recurrence and follow-up time. Results: The duration of the complaint ranged from one month to four years (mean 24.5 months). While a single sinus orifice was detected in the midline in 45 cases (43.3%), two or more sinus orifices were detected in the midline in 59 cases (49.7%). The operation time was shorter in Group 2 than in Group 1. The difference was statistically significant. wound dehiscence was significantly less common in Group 2. In terms of recurrence and aesthetic satisfaction, aesthetic satisfaction was significantly higher in Group 2. Conclusion: Our study showed that adipofascial flap, which can be easily applied in the surgical treatment of pilonidal sinus disease and has no difference from other flap methods, is a method that can be safely applied in the treatment of this disease.