Skip to main content

Advertisement

SpringerLink
Log in

The effects of drainage on the rates of early wound complications and recurrences after Limberg flap reconstruction in patients with pilonidal disease

  • Original Article
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Background

Cavity drainage has been used routinely in Limberg flap repair for pilonidal disease but there have been few controlled studies on the rationale for routine usage of drains. The aim of this study was to determine whether routine cavity drainage affects the rates of early wound complications and recurrences after rhomboid excision with Limberg flap repair for pilonidal disease.

Methods

Sixty patients with pilonidal disease in the sacrococcygeal region were randomized sequentially into 2 groups as drained or non-drained. All of them underwent rhomboid excision and Limberg flap reconstruction. The patients were followed up by physical examination at 2 and 4 weeks after the operation and every 6 months thereafter.

Results

Two patients in the drained group and 3 patients in the non-drained group were excluded from the study because of non-attendance at the follow-up physical examinations. The average length of hospital stay was 3.1 ± 0.9 and 3.3 ± 0.8 days in the drained and non-drained groups, respectively. There were 5 seromas, 2 wound dehiscences and 1 hematoma in the non-drained group, while 3 seromas and 2 wound dehiscences developed in the drained group. The complication rates of groups were similar (29.6% in the non-drained group vs. 17.8% in the drained group). Pilonidal disease recurred in 2 patients in the drained group who had wound dehiscence and in 3 patients in the non-drained group who had wound dehiscence or seroma.

Conclusions

Routine usage of drains for Limberg flap reconstruction in the sacrococcygeal region did not affect wound-related complications and recurrence rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Topgul K, Ozdemir E, Kilic K, Gokbayir H, Ferahkose Z (2003) Long-term results of limberg flap procedure for treatment of pilonidal sinus: a report of 200 cases. Dis Colon Rectum 46:1545–1548

    Article  PubMed  Google Scholar 

  2. Karydakis GE (1992) Easy and successful treatment of pilonidal sinus after explanation of its causative processes. ANZ J Surg 62:385–389

    Article  CAS  Google Scholar 

  3. Tritapepe R, Di Padova C (2002) Excision and primary closure of pilonidal sinus using a drain for antiseptic wound flushing. Am J Surg 183:209–211

    Article  PubMed  Google Scholar 

  4. Akinci OF, Coskun A, Uzunkoy A (2000) Simple and effective surgical treatment of pilonidal sinus: asymmetric excision and primary closure using suction drain and subcuticular skin closure. Dis Colon Rectum 43:701–706

    Article  PubMed  CAS  Google Scholar 

  5. Erdem E, Sungurtekin U, Nessar M (1998) Are postoperative drains necessary with the Limberg flap for treatment of pilonidal sinus? Dis Colon Rectum 41:1427–1431

    Article  PubMed  CAS  Google Scholar 

  6. Gurer A, Gomceli I, Ozdogan M, Ozlem N, Sozen S, Aydin R (2005) Is routine caviy drainage necessary in Karydakis flap operation? A prospective, randomized trial. Dis Colon Rectum 48:1797–1799

    Article  PubMed  Google Scholar 

  7. Mahdy T (2008) Surgical treatment of the pilonidal disease: primary closure or flap reconstruction after excision. Dis Colon Rectum 51:1816–1822

    Article  PubMed  CAS  Google Scholar 

  8. Jamal A, Shamim M, Hashmi F, Qureshi MI (2009) Open excision with secondary healing versus rhomboid excision with Limberg transposition flap in the management of sacrococcygeal pilonidal disease. J Pak Med Assoc 59:1560–1571

    Google Scholar 

  9. Azab AS, Kamal MS, Saad RA, Abou al Atta KA, Ali NA (1984) Radical cure of pilonidal sinus by a transposition rhomboid flap. Br J Surg 71:154–155

    Article  PubMed  CAS  Google Scholar 

  10. Ersoy OF, Karaca S, Kayaoglu HA, Ozkan N, Celik A, Ozum T (2007) Comparison of different surgical options in the treatment of pilonidal disease: retrospective analysis of 175 patients. Kaohsiung J Med Sci 23:67–70

    Article  PubMed  Google Scholar 

  11. Akin M, Gokbayir H, Kilic K, Topgul K, Ozdemir E, Ferahkose Z (2008) Rhomboid excision and Limberg flap for managing pilonidal sinus: long-term results in 411 patients. Colorectal Dis 10:945–948

    PubMed  CAS  Google Scholar 

  12. Mentes O, Bagci M, Bilgin T, Ozgul O, Ozdemir M (2008) Limberg flap procedure for pilonidal disease: results of 353 patients. Langenbeck’s Arch Surg 393:185–189

    Article  Google Scholar 

  13. Kapan M, Kapan S, Pekmezci S, Durgun V (2002) Sacrococcygeal pilonidal sinus disease with Limberg flap repair. Tech Coloproctol 6:27–32

    Article  PubMed  CAS  Google Scholar 

  14. Daphan C, Tekelioglu MH, Sayilgan C (2004) Limberg flap repair for pilonidal sinus disease. Dis Colon Rectum 47:233–237

    Article  PubMed  Google Scholar 

  15. Colak T, Turkmenoglu O, Dag A, Akca T, Aydin S (2010) A randomized linical study evaluating the need for drainage after Limberg flap for pilonidal sinus. J Surg Res 158:127–131

    Article  PubMed  Google Scholar 

  16. Cihan A, Mentes BB, Tatlicioglu E, Ozmen S, Leventoglu S, Ucan BH (2004) Modified Limberg flap reconstruction compares favourably with primary repair for pilonidal sinus surgery. ANZ J Surg 74:238–242

    Article  PubMed  Google Scholar 

  17. Akin M, Leventoglu S, Mentes BB et al (2010) Comparison of the classic Limberg flap and modified Limberg flap in the treatment of pilonidal sinus disease: a retrospective analysis of 416 patients. Surg Today 40:757–762

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

I declared that any of the authors has personal conflict of interest. This study was not supported by any financial institution.

Author information

Authors and Affiliations

  1. Medicine Faculty, Department of General Surgery, Firat University, Elazığ, 23169, Turkey

    C. Kırkıl, E. Aygen & K. Karabulut

  2. Medicine Faculty, Department of General Surgery, Dicle University, Diyarbakir, Turkey

    A. Böyük

  3. Department of General Surgery, Antalya Education and Research Hospital, Antalya, Turkey

    N. Bülbüller

  4. Department of General Surgery, Bafra State Hospital, Samsun, Turkey

    S. Coşkun

Authors
  1. C. Kırkıl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Böyük
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. Bülbüller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Aygen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Karabulut
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Coşkun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Kırkıl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kırkıl, C., Böyük, A., Bülbüller, N. et al. The effects of drainage on the rates of early wound complications and recurrences after Limberg flap reconstruction in patients with pilonidal disease. Tech Coloproctol 15, 425–429 (2011). https://doi.org/10.1007/s10151-011-0782-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10151-011-0782-5

Keywords

Search

Navigation