Habibullah Shah, Muhammad Iftikhar, Huma Gul, Rashid Khan.
Pilonidal sinus: comparative analysis of outcomes for limberg flap versus open healing techniques.
Pak J Surg Jan ;32(3):150-5.

Objective: To investigate the surgical outcome for patients of pilonidal sinus disease undergoing limberg flap technique versus open healing in terms of healing times, return to work and overall satisfaction. Methods: Th is is a retrospective review of prospectively collected data. 69 patients were operated between January 2009 and December 2014 at Peshawar Institute of Medical Sciences, Habib Medical Centre. Patients underwent excision of the pilonidal sinus with closure as limberg flap technique (group A) or healing by second intention (group B). Data was collected in a prospective manner and the patients were followed for two years. Th e operative and postop data was collected for procedure time, length of stay (LOS), return to work (RTW) time, total healing time (THT), the occurrence of complications, recurrence and overall patient satisfaction on a five point Likert scale. Results: A total of 69 patients were included, 40 (58.0%) in group A (Limberg flap repair) and 29 (42.0%) in group B (open technique). Overall mean age was 27.6 years ±5.78 SD. All patients were male. Mean operative time group A was 67.28 minutes ± 14.29 SD while for group B it was 38.66 minutes ± 4.90 SD. Th ere was a significantly shorter duration in rates of wound healing (p <0.0001), return to work (p<0.0001) and total hospital stay (p = 0.001) for the limberg flap group as compared to open healing group. Th ere was a significantly higher satisfaction rates for limberg group (p = 0.005). Conclusion: Limberg flap technique is an effective method of pilonidal sinus surgical treatment with significantly shorter hospital stay, early return to work and rapid wound healing. Patient satisfaction is higher for Limberg flap technique as compared to open wound healing.

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