Comparison of Limberg and Dufourmentel flap in surgical treatment of pilonidal sinus disease
Ali Tardu1, Adnan Haşlak2, Beyza Özçınar2, Fatih Başak1
1İstanbul Eğitim ve Araştırma Hastanesi, Genel Cerrahi, İstanbul, Türkiye
2Ergani Devlet Hastanesi, Genel Cerrahi, Diyarbakır, Türkiye
Purpose: Pilonidal sinus is a common chronic disease relating sacrococcygeal region. Although several surgical treatment methods were determined relating pilonidal sinus, no optimal treatment method is available because of its high recurrence rates. This study was designed to compare Limberg and Dufourmentel flap methods that are currently used.
Patients and Methods: This study is a clinical study including patients admitted to our hospital and diagnosed as chronic pilonidal sinus disease between 2004 to 2007.
Patients were divided into two groups. Romboid sinus excision with Limberg flap method was performed to first group named as group L included 50 patients.
Romboid sinus excision with Dufourmentel flap method was performed to second group named as group D included 50 patients. Patients had complicated or recurrent pilonidal sinus and patients with infection were excluded.
Results: When parameters related to early term complication were taken into account, there were no differences between the groups regarding seroma and wound dehiscence, although infection and hematoma were significantly less in group D patients. When parameters related to late term complication were taken into account no significant differences were detected between groups regarding sensory loss, pain, itching, and cosmetic worry. Two patients in group D and three patients in group L had recurrent pilonidal sinus in present study. However, no satistical significance was found between groups in term of recurrence.
Conclusion: There are very different surgical and non-surgical treatment choices for treatment of pilonidal sinus. Not any treatment method absolutely prevent recurrence. The lowest recurrence rates were reported with primary excision and Romboid flap method in current literature. We suggest that Dufourmentel flap method could be used as an alternative to Limberg flap method in treatment of pilonidal sinus because of its lower infection and hematoma rates, although time of hospitalisation, late complications and recurrence rates are similar compared to Limberg flap method.
Keywords: Pilonidal sinus, Limberg flap, Dufourmentel flap