Skip to main content
SpringerLink
Log in

Effectiveness and Feasibility of Limberg and Karydakis Flap in Recurrent and Complicated Pilonidal Sinus Disease

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

The aim of this study is to evaluate the effectiveness and feasibility of Limberg and Karydakis flap in complicated and recurrent cases of pilonidal sinus. This study was performed on 54 patients with complicated or recurrent (PSD) who referred to Minya University Hospital from January 2018 to January 2019. Patients were randomly divided into two groups, group A who were subjected to the Limberg flap and group B who were subjected to the Karydakis flap technique. Regarding postoperative complications, the occurrence of wound breakdown in the Karydakis group was 40.7% versus 11.1% in the Limberg group. No recurrence occurred in the Limberg group but recurrence observed in six cases in the Karydakis group. In the Karydakis group, eight patients had infection in comparison to one case in the Limberg group. All these differences were statistically significant. The overall patient satisfaction in the Limberg group was significantly higher than that in the Karydakis group. It is concluded that Limberg flap rotation is clearly preferred in management of recurrent and complicated PNS for safety reasons given its low recurrence and postoperative complication 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
Fig. 2

Similar content being viewed by others

References

  1. Petersen S, Koch R, Stelzner S, Wendlandt TP, Ludwig K (2002) Primary closure techniques in chronic pilonidal sinus: a survey of the result of different surgical approaches. Dis Colon Rectum 45(11):1458–1462

    Article  Google Scholar 

  2. Bertelsen CA (2011) Cleft-lift operation for pilonidal sinuses under tumescent local anesthesia: a prospective cohort study of peri- and postoperative pain. Dis Colon Rectum 54(7):895e900

    Article  Google Scholar 

  3. Muzi MG, Milito G, Cadeddu F, Nigro C, Andreoli F, Amabile D, Farinon AM (2010) Randomized comparison of Limberg flap versus modified primary closure for the treatment of pilonidal disease. Am J Surg 200(1):9–14

    Article  Google Scholar 

  4. Krand O, Yalt T, Berber I, Kara VM, Tellioglu G (2009) Management of pilonidal sinus disease with oblique excision and bilateral gluteus maximus fascia advancing flap: result of 278 patients. Dis Colon Rectum 52:1172–1177

    Article  Google Scholar 

  5. Can MF, Sevinc MM, Hancerliogullari O, Yilmaz M, Yagci G (2010) Multicenter prospective randomized trial comparing modified Limberg flap transposition and Karydakis flap reconstruction in patients with sacrococcygeal pilonidal disease. Am J Surg 200(3):318–327

    Article  Google Scholar 

  6. Bessa SS (2013) Comparison of short-term results between the modified Karydakis flap and the modified Limberg flap in the management of pilonidal sinus disease: a randomized controlled study. Dis Colon Rectum 56(4):491–498

    Article  Google Scholar 

  7. Humphries AE, Duncan JE (2010) Evaluation and management of pilonidal disease. Surg Clin North Am 90(1):113–124

    Article  Google Scholar 

  8. Søndenaa K, Nesvik I, Andersen E, Natås O, Søreide JA (1995) Bacteriology and complications of chronic pilonidal sinus treated with excision and primary suture. Int J Color Dis 10:161–166

    Article  Google Scholar 

  9. Lieto E, Castellano P, Pinto M, Zamboli A, Pignatelli C, Galizia G (2010) Dufourmentel rhomboid flap in the radical treatment of primary and recurrent sacrococcygeal pilonidal disease. Dis Colon Rectum 53(7):1061–1068

    Article  Google Scholar 

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

    Article  Google Scholar 

  11. Lee PJ, Raniga S, Biyani DK, Watson AJ, Faragher IG, Frizelle FA (2008) Sacrococcygeal pilonidal disease. Color Dis 10(7):639–650

    Article  CAS  Google Scholar 

  12. Ersoy E, Devay AO, Aktimur R, Doganay B, Ozdoğan M, Gundoğdu RH (2009) Comparison of the short-term results after Limberg and Karydakis procedures for pilonidal disease: randomized prospective analysis of 100 patients. Color Dis 11(7):705–710

    Article  CAS  Google Scholar 

  13. Alvandipour M, Zamani MS, Ghorbani M, Charati JY, Karami MY (2019) Comparison of Limberg flap and Karydakis flap surgery for the treatment of patients with pilonidal sinus disease: a single-blinded parallel randomized study. Ann Coloproctol; 1–6

  14. Kohla SM, Alsesy AA, Abd El-Aziz TF, Mohammed MA, Abo Zaid MA (2016) Comparative study between the Karydakis technique and the Limberg flap in pilonidal sinus. Menoufia Med J 29:539–544

    Article  Google Scholar 

  15. Bostanoglu S, Sakcak I, Avsar FM, Cosgun E, Hamamci EO (2010) Comparison of Karydakis technique with Limberg flap procedure in pilonidal sinus disease: advantages of Karydakis technique. Pak J Med Sci 26(4):773–777

    Google Scholar 

  16. Karaca T, Yoldaş O, Bilgin BÇ, Ozer S, Yoldaş S et al (2012) Comparison of short-term results of modified Karydakis flap and modified Limberg flap for pilonidal sinus surgery. Int J Surg 10(10):601–606

    Article  Google Scholar 

  17. Arslan K, Said Kokcam S, Koksal H, Turan E, Atay A, Dogru O. Which flap method should be preferred for the treatment of pilonidal sinus? A prospective randomized study. Tech

  18. McCallum IJ, King PM, Bruce J (2008) Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ 336(7649):868–871. https://doi.org/10.1136/bmj.39517.808160.BE

    Article  PubMed  PubMed Central  Google Scholar 

  19. Petersen S, Koch R, Stelzner S, Wendlandt TP, Ludwig K (2002) Primary closure techniques in chronic pilonidal sinus: a survey of the - results of different surgical approaches. Dis Colon Rectum 45(11):1458–1467. https://doi.org/10.1007/s10350-004-6451-2

    Article  PubMed  Google Scholar 

  20. Ashok, Nikhilesh (2018) Comparison of Karydakis flap and Limberg flap in pilonidal sinus. Int J Surg Surg Tech 2(2):1–4

    Google Scholar 

Download references

Acknowledgments

The authors would like to offer their sincere thanks to all patients and their relevant.

Author information

Authors and Affiliations

  1. General Surgery Department, Faculty of Medicine, Minia University, Minia, Minia Governorate, 61111, Egypt

    Amr Abdel Hameed Elhiny, Doaa Ali Saad & Mohamed Sadek Farahat

Authors
  1. Amr Abdel Hameed Elhiny
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Doaa Ali Saad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohamed Sadek Farahat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amr Abdel Hameed Elhiny.

Ethics declarations

The protocol of the study was discussed and approved regarding ethics of research in the general surgical department. The study had been approved by the ethical committee for human studies in our institution. Full written, informed consent was signed from all participants.

Conflict of Interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Manuscript has been read and approved by all the authors

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elhiny, A.A.H., Saad, D.A. & Farahat, M.S. Effectiveness and Feasibility of Limberg and Karydakis Flap in Recurrent and Complicated Pilonidal Sinus Disease. Indian J Surg 83, 55–60 (2021). https://doi.org/10.1007/s12262-020-02236-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-020-02236-5

Keywords

Search

Navigation