OUR EXPERIENCE OF RHOMBOID EXCISION WITH LIMBERG FLAP RECONSTRUCTION IN PILONIDAL SINUS DISEASE

Background: Pilonidal sinus is a hair containing sinus at the cleft of buttocks. The treatment should have rapid cure that allows patients to return quickly to their normal activities, with minimum morbidity. Limberg flap reconstruction of pilonidal sinus is frequently performed at our centre. Methods and Patients: This prospective study was conducted in the department of surgery rural centre of Kashmir from November 2013 to February 2015. A total number of 25 patients were treated with rhomboid excision with limberg flap reconstruction during this period. Parameters like postoperative complications, hospital stay, time off-work and recurrences were recorded. The patients were followed in the outpatient department for a period of six months. Results: Of the 25 patients in our study 15 patients presented with a discharging sinus, 6 patients presented with pain, 2 with abscess and 2 with infection. In our study the operative time ranged from 50 minutes to 90 minutes. Drain was removed after 48-72 hours and patients were discharged the same day as the removal of drain. Sutures were removed on 12th – 15th postoperative day. One patient in our study developed wound site infection, one patient had seroma, while as one patient had flap necrosis at the tip of the flap. Overall only one patient had a recurrence during the follow-up. Conclusion: Rhomboid excision with limberg reconstruction flap procedure is a very effective procedure for pilonidal sinus disease. It is associated with a low recurrence, a shorter hospital stay, less complication rates and faster healing.