Background: Pilonidal sinus is a chronic intermittent disease that typically affects
the sacrocygeal zone. It usually affects young and middle-aged males. For more
than a century, surgeons have have been using different treatment modalities to
treat this disease, including both simple and complex procedures like laying
open of tract, simple excision, marsupialization, karydakis procedure and
limberg flap closure.
Aim: To compare the outcome of rhomboid flap
excision versus ellipticalexcision in primary closure for management of
patients undergoing surgery for sacrococcygeal pilonidal sinus.
Methods: A Randomized controlled trial was
conducted in West Surgery Ward,
Department of Surgery,
Mayo Hospital, Lahore from August
17, 2016 to July 17, 2017. This study included 120
patients suffering acute primary sacrococcygeal pilonidal sinus. Patients were
allocated randomly into groups A &
B: One group included patients with Excision and primary closure while other included patients undergoing
modified Limberg flap procedure respectively.
Postoperative complications, length of hospital stay and duration of disease
were recorded. Using SPSS v24.0 the data was entered and analysed..
mean age of the patients was 30.15±6.12 years. In Group-A & B, mean
duration of disease was 14.82±3.34 and
7.67±1.73 days respectively. Mean hospital stay was 4.34±1.59 days in Group-A,
while it was 3.43±1.10 days in Group-B.
Comparing group A & B, rates of wound infection, edema and wound dehiscence
were 8(13.1%) vs 3 (4.9%), 7(11.5%) vs 2
(3.3%) and 4(6.6%) vs 1(1.6%) respectively.
Conclusion: The outcome of rhomboid excision with limberg flap closure is safer for
people having sacrococcygeal pilonidal sinus surgery than for elliptical
excision with primary closure in terms of hospital stay, wound dehiscence,
wound infection and oedema.
Pilonidal sinus, simple excision, Rhomboid excision, limberg flap