Comparison between Limberg's Flap and Wide Excision in the Treatment of Sacrococcygeal Pilonidal Disease

Objective. A Comparative study of management strategy for sacrococcygeal pilonidal disease-Wide excision & Secondary healing vs Limbergs Flap surgery. Design Prospective observational clinical study of 30 cases. Setting Hindustan Aeronautics Ltd Hospital, Bangalore, Karnataka Material & method Study design - Randomized prospective open labeled comparative study Sample population The OPD/IPD patients who shall be treated for pilonidal disease (sinus, cyst or abscess) in Hindustan Aeronautics Limited Hospital, Bangalore from April 2012 to June 2014. Patients will be randomly be assigned to group 1 or group2. Group1- will undergo wide excision for pilonidal disease. Group 2- will undergo Limbergs flap surgery. Patients will be followed up till June 2014. Patient will also be followed up for recurrence, duration of hospital stay, duration of incapacity to work, time required for complete healing, post operative complications. Results Incidence of Seroma in the with wide excision and secondary healing in the present study also was 0 %. It was significantly more associated with wide excision and secondary healing (P=0.024). We observed that Mean number of hospital stay is significantly shorter in patients who underwent Limberg flap surgery 5.271.14 days as compared to those Wide Excision with secondary healing 7.671.29 days with Pless than0.001. In the present study Mean number of dressings in Limbergs Flap were found to be 5.904.75 whereas with Wide excision and secondary healing it was observed to be 15.733.07. Hence Mean number of dressings in Limbergs Flap are significantly less than with Wide excision and secondary healing. (Pless than0.001**). Conclusions Incidence of post operative complications after limbergs flap surgery are similar to those after wide excision. Number of days in hospital, number of days of loss of work and time taken for complete healing is significantly reduced in limbergs flap surgery. Limbergs flap surgery is more cost effective treatment option when compared with wide excision with secondary healing. Incidence of recurrence is statistically similar in two groups. Hence limbergs flap surgery is better surgical treatment in pilonidal sinus disease.