Pilonidal Sinus – A Classical Plastic Procedure according to Limberg (Limberg Flap Procedure) or Its Modified Version?

Authors: M. Kička;  T. Toporcer;  J. Radoňak
Authors‘ workplace: I. chirurgická klinika UNLP, Košice, Slovenská republika, prednosta: prof. MUDr. Jozef Radoňak, CSc.
Published in: Rozhl. Chir., 2011, roč. 90, č. 8, s. 482-487.
Category: Monothematic special - Original


Pilonidal sinus disease (PSD) is defined as a cyst of sacrococcygeal hair follicle. Complete excision of lesion and skin reconstruction is still the only definitive treatment. Opinions on form and size of excision and type of skin reconstruction and flap are ambiguous.

Retrospective analysis of 83 patients underwent surgery in I. Department of Surgery in Kosice because of chronic PSD was performed. 67 patients underwent excision with Limberg flap (LF). 16 patients underwent excision with modified Limberg flap (mLF). 19 and 3 patients were excluded because of absence of control evaluation. The control evaluations of 48 and 13 patients were performed 12 days and 12 mounts after surgery.

No differences between groups in age of patients and men to women rate were recorded. We have recorded shorter hospital time (LF: 4 days; mLF: 3 days) and lower incidence of disease recurrence in one year (LF: 6.25%; mLF: 0%) in modified Limberg flap group.

Using of flaps in PSD treatment decrease suture tension and minimize risk of suture dehiscence, postoperative tenderness and risk of other complications. Using of flaps in treatment of this disease reduce intergluteal groove and minimize risk of disease recurrence. Using of primary closure without flap carries just little benefit in shorter surgery time. Suture outside of midline minimize risk of early postsurgical complication and decrease risk of disease recurrence.

Published literature in correlation with our results show that modified Limberg flap may be useful standard in PSD treatment.

Key words:
pilonidal sinus – Limberg flap – modified Limbergt flap


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