A Study to Evaluate Outcome of Pilonidal Sinus Treatment after Various Surgical Techniques

Background: Pilonidal disease is a type of skin infection which typically occurs as a cyst between the cheeks of the buttocks and often at the upper end. Symptoms may include pain swelling and redness Risk factors include obesity family history prolonged sitting greater amounts of hair and not enough exercise . Shaving the area and laser hair removal may prevent recurrence .About 3 per 10,000 people per year are affected and it occurs more often in males than females . Young adults are most commonly affected The term pilonidal means nest of hairGood technique less incidence of recurrence less morbidity less duration of hospital stay and good patient compatibility have made these procedures popular and acceptable with minimal cosmetic disfigurement.Though many techniques are practiced, the LIMBERG?SRHOMBOID FLAP is one of the flap technique that was found to be efficient in the management of this condition. Aims and objectives: 1 To determine effects of Limberg flap rotation surgery their outcomes such as wound infection seroma formation flap necrosis 2To compare the result of excision of sinus followed by dressing of wound versus closure of wound by Limberg flap closure Z-plasty3To assess the recurrence rate of pilonidal sinus disease in patients with effective removal of pilonidal sinus. Materials and Methods: The study has been conducted in department of general surgery Associate LLR hospital GSVM medical college Kanpur from January 2019 to October 2021 on patients who were admitted from casualty and Outpatient departments of general surgery. Total 100 patients where taken. A Performa has been designed which included demographic data signs symptoms predisposing risk factors investigations diagnosis type of operative technique operative time and complications BMI greater than35 kg/m 2 will be considered to be overweight and obese. Results: A total 100 patients were included in the study findings noted appropriate treatment instituted and followed up for a period of 6months.Pilonidal disease have been reported, due to various predisposing factors, more common in males(84%) compared to the females(16%).It affects young adults(20-24yrs-42%) Presentation may vary from asymptomatic pits to chronic pain(88%) and discharging sinuses(38%) and acute presentations of abscess.Patients with an increased body mass index and those with a deep natal cleft are more prone for it.Patients who work for prolonged sittingare more prone to develop this disease.There are a wide variety of treatments both surgical and non-surgical that are advocated in the management of pilonidal disease.Among all, it is the flap procedures which have a low recurrence, less duration of hospital stay and early return to work. Limberg flap is the most effective surgery .Conclusions: A disease of the natal cleft affecting young adults with a male preponderance and occupation involving prolonged sittingwith presentation vary from painful discharging sinus to acute abscess.The current published literature supports the use of the rhomboid flap excision and the limberg flap-repaire procedures over primery midline suture techniques for the effective management of primery pilonidal disease. Flap procedures are the most effective way to treat the disease.