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Evaluation of the Outcomes of Rhomboidal Flap "Limberg Flap” Repair Procedure for Sacroccocygeal Pilonidal Sinus Disease in Baghdad Teaching Hospital

Author: Saad A.Sarsam , Sabah M.fatlawi , Ahmed M.Salih
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2019 Volume: 18 Issue: 1 Pages: 62-67
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


ABSTRACT:BACKGROUND:Saccrococygeal Pilonidal sinus is a common surgical condition and its management is stilldebatable, as many surgical techniques were developed aiming to improve outcome, better patientsatisfaction, and most importantly to prevent recurrence. Rhomboidal flap procedure "limberg flap"is very safe and effective method for pilonidal sinus treatment due to its low complication ratespecially recurrence hence in this study we address the role of limberg flap procedure inmanagement of pilonidal sinus and how its complications are.OBJECTIVE:To analyze the outcome of "Limberg" Rhomboidal flap, in managing sacrococcygeal Pilonidalsinus as a novel, with a potentially less complication and recurrence rate surgical procedure.PATIENT AND METHOD:This is a prospective study on 44 patients suffered from sacroccocygeal pilonidal sinus, 36 patientswith primary disease and 8 patients had recurrent or previously managed pilonidal sinus collectedrandomly in the 5th floor surgical department in Baghdad teaching hospital from June 1st 2014 toDecember 10th 2015. All underwent rhomboidal flap procedure .there was no exclusion criteria,data collected included demographic distribution, primary or recurrent pilonidal sinus, woundcomplications, and recurrence. The minimum follow up period was 1 year after surgery.RESULTS:44 patients had undergone this procedure most of them were males (41 patients), and(3 patients) were females, youngest patient was a 16-year old and oldest one was 41-year old. Meanagewas26. 1years±5.6SD, 5 patients (11.4%) had a previous formal surgical repair of pilonidalsinus, 3 patients (6,8%) had a previous drainage of pilonidal abscess. The mean duration of thedisease is 10.9 months±6.9 SD.Our finding revealed that 3(6.8%) patients developed seroma ,2(4,5%)patients had wound infection that all responded to conservative treatment. Other suspectedcomplications including flap necrosis, wound dehiscence and hematoma were not reported with anyof our patients.CONCLUSION:Rhomboid flap is very safe and effective method for treatment of pilonidal sinus disease due to itslow complication rates especially recurrence of pilonidal disease, it also offers a good patientsatisfaction, although this procedure takes a longer operating time than the classical methods but itis easy to be learned and practiced with efficiency .

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