The Limberg Flap Procedure in the Treatment of Pilonidal Cyst Disease of the Sacrum – Initial Report
Languages of publication
Pilonidal cyst disease mainly concerns young people, aged between 16 and 25 years. The disease causes significant pain, considerable discomfort and impairs daily functioning, often resulting in an inability to work and study. Many techniques have been introduced in the treatment of pilonidal cysts, but till today no gold standard has been established. The aim of the study was to present initial results considering the treatment of pilonidal cyst disease with the use of a skin flap by means of Limberg’s method. Material and methods. During the period between January, 2012 and March, 2013, 10 patients were operated due to pilonidal cysts using the Limberg flap procedure. All patients presented with the chronic form of the disease and were after previous surgical incisions. Pain considering patients was evaluated using the visual pain scale (VAS), one and 10 days after the operation. Patients reported for control 10 days, one month, and 6 months after the surgical procedure. Results. The planned procedure was safely performed in all cases. There were no complications during the procedure, nor late postoperative complications. We observed no wound infection or dehiscence in all operated patients. The mean follow-up time of the presented group was 13.32 months (ranging between 7.53‑21.57). During the follow-up period there was no episode of recurrence. Conclusions. The use of the skin flap by means of Limberg’s method after excision of the pilonidal cyst in the sacrum area is a good method, which provides a very low percentage of recurrences and complications. Fast return to daily activities, no significant pain in patients, and an acceptable cosmetic result are strong reasons in favor of the above-mentioned method. Preliminary observations and experience enable to recommend this method for the treatment of pilonidal cysts in the vicinity of the sacrum
1 - 6 - 2014
13 - 4 - 2014
2 - 9 - 2014
- 1. Chintapatla S, Safarani N, Kumat S et al.: Sacrococcygeal pilonidal sinus: historical review, pathological in sight and surgical options. Tech Coloproctol 2003; 7: 38.
- 2. Price ML, Griffiths WAD: Normal body hair: a review. Clin Exp Dermatol 1985; 10: 8797.
- 3. Bascom JU: Pilonidaldisease: correcting over treatment and under treatment. Contemp Surg 1981; 18: 1328.
- 4. Clothier PR , HaywoodI R: The natural history of the postanal (pilonidal) sinus. Ann R Coll Surg Engl 1984; 66: 20103.
- 5. Buie LA: Jeep disease. South Med J 1944; 37: 103.
- 6. Millar DM: Etiology of post-anal pilonidal disease. Proc R Soc Med 1970; 63: 126364.
- 7. Stansby G, Greatorex R: Phenol treatment of pilonidal sinuses of the natal cleft. Br J Surg 1989; 76: 729.
- 8. Miller RJ, Mucha S, Lowery C, Turville WC : Pilonidaldisease. A logical approach. Postgrad Med 1967; 41: 38285[PubMed]
- 9. King ES: The nature of the pilonidal sinus. Aust N Z J Surg 1947; 16: 18292.
- 10. Lord PH , Millar DM: Pilonidal sinus: a simple treatment. Br J Surg 1965; 52: 298300.
- 11. Harlak A, Mentes O, Kilic S et al.: Sacro-coccygeal pilonidal disease: analysis of previous lyproposedrisk factors. Clinics (Sao Paulo) 65: 125131+
- 12. Klass AA: The so-calledpilonidal sinus. Can Med Assoc J 1956; 75: 73742.
- 13. Aydede H, Erhan Y, Sakarya A, Kumkumoglu Y: Comparison of three methods in surgical treatment of pilonidal disease. J Surg 2001; 71: 36974.
- 14. Kement M, Oncel M, Kurt N, Kaptanoglu L: Sinus excision for the treatment of limited chronic pilonidal disease: results after a medium term follow up. Dis Colon Rectum 2006; 49: 1758‑62.[Crossref][PubMed]
- 15. Surrel JA: Pilonidal disease. Surg Clin North Am 1994; 74: 130915.
- 16. Erdem E, Sungurtekin U, Nessar M: Are postoperative drains necessary with the Limberg flap for treatment of pilonidal sinus? Dis Colon Rectum 1998; 41: 142131.
- 17. Marks J, Harding KG, Hughes LE, Ribeiro CD : Pilonidal sinus: excision-healing by open granulation. Br J Surg 1985; 72: 63740.
- 18. McCallum I, King PM, Bruce J: Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev 2007; CD006213
- 19. Karydakis GE: Easy and successful treatment of pilonidal sinus after explanation of it scausative processes. ANZ J Surg 1992; 62: 38589.
- 20. Atka T, Colak T, Ustonsoy B, Kanik A, Aydin S: Randomized clinical trial comparing closure with the Limberg flap in the treatment of primary sacrococcygeal pilonidal disease. Br J Surg 2005; 92: 108184.
- 21. Horwood J, Hanratty D, Chandran P, Billings P: Primary closure orrhomboidexcision and Limberg flap for the management of primary sacrococcygeal pilonidal disease? A meta-analysis of randomized controlled trias. Colorectal Disease 2011; 14: 14351.[WoS]
- 22. Can MF, Sevinc MM, Hancerliogullari O et al.: Multi center prospective randomized trial comparing modified Limberg flap transposition and Karydakis flap reconstruction in patients with sacrococcygeal pilonidal disease Am J Surg 2010 Sep; 200(3): 31827.[WoS]
- 23. Karaca T, Yoldas O,ÇaglarBilgin B et al.: Comparison of short-term results of modified Karydakis flap and modified Limberg flap for pilonidal sinus burger. Int J Surg 2012; 10: 60106.[WoS]
- 24. Ersoy E, Devay AO, Aktimur R et al.: Comparison of the short-term results after Limberg and Karydakis procedures for pilonidal disease: randomized prospective analysis of 100 patients. Colorectal Dis 2009; 11: 70510.[WoS]
- 25. Guner A, Boz A, Ozkan O et al.: Limberg Flap Versus Bascom Cleft Lift Techniques for Sacro-coccygeal Pilonidal Sinus: Prospective, Randomized Trial . DOI 10 . 1007 / s0026801321119[Crossref]
- 26. Muzi M, Milito G, Nigro F et al.: A modification of primaryclosure for the treatment of pilonidal disease in day-caresetting. Colorectal Dis 2008; 11: 8488.
Publication order reference