Muzaffar Aziz, Tariq Jamil Choudhary, Jamil Zahid, Khalid Hussain Qureshi.
Surgical Excision With Secondary Healing Versus Limberg Transposition Flap In The Management Of Sacrococcygeal Pilonidal Disease.
Esculapio J Services Inst Med Sci Jan ;13(1):10-3.

Objective: To compare the outcome of Open excision and secondary healing with rhomboid excision and Limberg flap in the management of sacrococcygeal pilonidal sinus disease. Methods: A comparative study using randomized controlled trial (RCT) was conducted at Nishtar Hospital Multan & Ghazi Khan teaching Hospital DG khan from November 2012 to July 2016. In total 49 patients, who either underwent open excision and secondary healing (group A: 25 patients out of which 4 patients did not reported during follow up so actual figure of 21 was included in this group) or rhomboid excision and Limberg flap (group B: 24 patients), were enrolled in the study. Duration of operation, postoperative pain, duration of hospital stay, postoperative complications, and time to recurrence were noted. The inclusion criteria were all patients with primary or recurrent Disease. Diabetics, patients with other co morbid condition, patients with poor follow up and patients with incomplete record were excluded from study. Results: Duration of operation was longer in group B patients (p=0.004) but pain perception was markedly reduced in this group (p=0.003). Total hospitalization period was shorter in patients in group B (p=0.002) and so was the time for complete healing of the wound (p=0.002). The recurrence rate was also significantly lower in patients who underwent Limberg rotation flap (p=0.005). Conclusion: Limberg flap is advantageous over simple excision and secondary healing in the management of pilonidal disease.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com