Alexandria Journal of Medicine

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Clinical trial comparing excision and primary closure with modified Limberg flap in the treatment of uncomplicated sacrococcygeal pilonidal disease

WG Elshazly, K Said


The aim of this study was to compare modified Limberg flap procedure with excision and primary closure in the treatment of uncomplicated pilonidal disease.
Methods: This study was conducted on 120 patients with uncomplicated sacrococcygeal pilonidal disease that were randomly allocated into two groups: group I underwent excision and primary closure; group II underwent modified Limberg flap procedure. The duration of operation, postoperative pain, length of hospital stay, duration of incapacity for work, postoperative complications and postoperative recurrence were recorded.
Results: Duration of operation was longer in group II than in group 1 (P < 0.001). However, postoperative pain was less (P< 0.001), duration of hospital stay shorter (P < 0.001), time to resumption of work shorter (P <0.001) and postoperative complications were significantly fewer in group
II. During follow-up period of 21.5 ± 6.82 (months) for group I and 22 ± 7.64 (months) for group II, single case of recurrence 1.67% was detected in patients in group II versus four patients (6.67% patients) in group I (P =0.032).
Conclusion: Wide excision with a modified Limberg transposition flap reconstruction is a very effective operative procedure for uncomplicated pilonidal sinus, associated with a low complication rate, short hospitalization and disability, and a low recurrence rate.
AJOL African Journals Online