Skip to main content
SpringerLink
Log in

Efficacy of modified Limberg flap in surgical treatment of infected pilonidal abscess: a case–control study

  • Original Article
  • Published:
European Surgery Aims and scope Submit manuscript

Summary

Objectives

Despite several surgical techniques in the treatment of pilonidal sinus, the ideal management is still under debate. Recently, Limberg flap has revealed promises owing to a lower recurrence rate. Our study aimed to assess mid-term outcomes of Limberg flap in patients with pilonidal abscesses.

Methods

Through a prospective case–control study, we enrolled 90 consecutive patients with pilonidal disease attending department of surgery in one of the university hospitals in Tehran, Iran, between January 2010 and April 2011. Patients with simple sinus (control group) underwent wide excision of the sinus, while those with infected pilonidal abscess received incision and drainage of the abscess and then excision (case group), and ultimately all the patients were treated with Limberg flap. Patients were followed by regular outpatient visits at 1 week, 2 weeks, 1 month, 6 months, and 1 year.

Results

Of 90 patients, 17 were in the case group (18.88 %) and 73 in the control group (81.12 %). All patients were treated with Limberg flap and then followed at regular outpatient visits for a median of 11 months. With regard to the early complications, hematoma occurred in one patient (1.4 %) and infection in three patients (4.1 %) of the control group, while late complications occurred only in two patients of the control group as paresthesia, which did not differ significantly.

Conclusions

This study showed that Limberg flap is effective in the surgical treatment of infected pilonidal abscess, with desirable mid-term outcomes.

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

Similar content being viewed by others

References

  1. Søndenaa K, Andersen E, Nesvik I, Søreide J. Patient characteristics and symptoms in chronic pilonidal sinus disease. Int J Colorectal Dis. 1995;10:39–42.

    Article  PubMed  Google Scholar 

  2. Harlak A, Mentes O, Kilic S, et al. Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors. Clinics (Sao Paulo). 2010;65:125–31.

    Article  Google Scholar 

  3. Akinci O, Bozer M, Uzunköy A, Duüzgün S, Cokun A. Incidence and aetiological factors in pilonidal sinus among Turkish soldiers. Eur J Surg. 1999;165(4):339–42.

    Article  CAS  PubMed  Google Scholar 

  4. Chintapatla S, Safarani N, Kumar S, Haboubi N. Sacrococcygeal pilonidal sinus: historical review, pathological insight and surgical options. Tech Coloproctol. 2003;7:3–8.

    Article  CAS  PubMed  Google Scholar 

  5. Da Silva J. Pilonidal cyst: cause and treatment. Dis Colon Rectum. 2000;43(8):1146–56.

    Article  CAS  PubMed  Google Scholar 

  6. Shabbir J, Chaudhary BN, Britton DC. Management of sacrococcygeal pilonidal sinus disease: a snapshot of current practice. Int J Colorectal Dis. 2011;26:1619–20.

    Article  CAS  PubMed  Google Scholar 

  7. Schoeller T, Wechselberger G, Otto A, Papp C. Definite surgical treatment of complicated recurrent pilonidal disease with a modified fasciocutaneous V-Y advancement flap. Surgery. 1997;121:258–63.

    Article  CAS  PubMed  Google Scholar 

  8. Kaya B, Eris C, Atalay S, Bat O, Bulut NE, Mantoglu B, et al. Modified Limberg transposition flap in the treatment of pilonidal sinus disease. Tech Coloproctol. 2012;16:55–9.

    Article  CAS  PubMed  Google Scholar 

  9. al-Hassan HK, Francis IM, Neglen P. Primary closure or secondary granulation after excision of pilonidal sinus? Acta Chir Scand. 1990;156(10):695–9.

    CAS  PubMed  Google Scholar 

  10. Eryilmaz R, Sahin M, Alimoglu O, Dasiran F. Surgical treatment of sacrococcygeal pilonidal sinus with the Limberg transposition flap. Surgery. 2003;134:745–9.

    Article  PubMed  Google Scholar 

  11. Azab A, Kamal M, Saad R, Abou A, Atta K, Ali NA. Radical cure of pilonidal sinus by a transposition rhomboid flap. Br J Surg. 1984;71:154–5.

    Article  CAS  PubMed  Google Scholar 

  12. Akin M, Leventoglu S, Mentes B, et al. 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. 2010;40:757–62.

    Article  PubMed  Google Scholar 

  13. Webb PM, Wysocki AP. Does pilonidal abscess heal quicker with off-midline incision and drainage? Tech Coloproctol. 2011;15:179–83.

    Article  CAS  PubMed  Google Scholar 

  14. Hosseini S, Bananzadeh A, Rivaz M, Sabet B, Mosallae M, Pourahmad S, et al. The comparison between drainage, delayed excision and primary closure with excision and secondary healing in management of pilonidal abscess. Int J Surg. 2006;4(4):228–31.

    Article  PubMed  Google Scholar 

  15. Vahedian J, Nabavizadeh F, Nakhaee N, Vahedian M, Sadeghpour A. Comparison between drainage and curettage in the treatment of acute pilonidal abscess. Saudi Med J. 2005;26(4):553–5.

    PubMed  Google Scholar 

  16. Licheri S, Pisano G, Erdas E, Farci S, Pomata M, Daniele G. Radical treatment of acute pilonidal abscess by marsupialization. G Chir. 2004;25(11–12):414–6.

    CAS  PubMed  Google Scholar 

  17. Ommer A, Pitt C, Albrecht K, Marla B, Peitgen K, Walz M. Pilonidal sinus—primary closure also in case of abscess? Zentralbl Chir. 2004;129(3):216–9.

    Article  CAS  PubMed  Google Scholar 

  18. Muller K, Marti L, Tarantino I, Jayne DG, Wolff K, Hetzer FH. Prospective analysis of cosmesis, morbidity, and patient satisfaction following Limberg flap for the treatment of sacrococcygeal pilonidal sinus. Dis Colon Rectum. 2011;54(4):487–94.

    Article  PubMed  Google Scholar 

  19. Schrogendorfer KF, Haslik W, Aszmann OC, Vierhapper M, Frey M, Lumenta DB. Prospective evaluation of a single-sided innervated gluteal artery perforator flap for reconstruction for extensive and recurrent pilonidal sinus disease: functional, aesthetic, and patient-reported long-term outcomes. World J Surg. 2012;36(9):2230–6.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

The authors report no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Niayesh Street, Sattarkhan Avenue, Tehran, Iran

    R. Azizi MD, M. Alemrajabi MD & S. Shoar MD

  2. Department of Surgery, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran

    M. Naderan MD & S. Shoar MD

Authors
  1. R. Azizi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Alemrajabi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Naderan MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Shoar MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Shoar MD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Azizi, R., Alemrajabi, M., Naderan, M. et al. Efficacy of modified Limberg flap in surgical treatment of infected pilonidal abscess: a case–control study. Eur Surg 46, 144–147 (2014). https://doi.org/10.1007/s10353-014-0273-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10353-014-0273-9

Keywords

Search

Navigation