A Comparison of the Excision Procedure and Flap Repair for the Pilonidal Sinus

Abstract

BACKGROUND:
The sacrococcygeal region is where a pilonidal sinus (PNS), a tiny opening in the subcutaneous tissue, most frequently forms. Making the optimum surgical treatment choice for PNS in terms of postoperative results is still difficult for a surgeon. The main objectives of treatment might be categorised as preventing the disease from returning and enhancing quality of life. It is regarded as an acquired lesion, and numerous hypotheses exist about its aetiology and pathogenesis. The main risk factors are a deep birth cleft, poor cleanliness, high hairiness, and local trauma in the sacrococcygeal area. The hair shafts that are shed when walking are forced into the skin abrasions in the gluteal sulcus. The formation of an acute or persistently infected location is caused by these hair shafts, which behave as a foreign body. The intergluteal sulcus is moist and fragile in obese patients, and this process is more apparent.
AIM: This study compared different surgical and postsurgical problems in pilonidal sinus treated with broad excision and Limberg flap repair techniques.
 MATERIAL AND METHOD:
In the Surgery Department, the study has been carried out. 35 patients made up the experimental group, who received primary closure of the pilonidal sinus utilising the Limberg flap technique, and 35 patients made up the control group, who underwent excision of the pilonidal sinus with primary closure only. To be determined appropriate for inclusion in this study, each case underwent a thorough examination and investigation. Patients were informed of the nature of surgical operations before giving their consent. Under spinal anaesthesia, every procedure was carried out. The research group had primary closure using the Limberg flap technique while the control group simply underwent excision with primary closure.
RESULTS:
The operative time period for the two procedures; was a mean of 39.4±4.5 (range 30-42) minutes for the Limberg flap procedure against a mean of 27.97±4.08 (range 20-30) minutes for primary midline closure. Infection at the stitch line occurs in a total of 12 patients out of which 1 patient is from the study group and patients are from the control group. This means infection at stitch line comparison was statistically significant. Seroma formations occur in a total of 10 patients out of which 1 patient is from the study group and patients are from the control group. This means seroma formation comparison was statistically significant. Wound dehiscence occurred in a total of 11 patients out of which 1  patient is from the study group and patients are from the control group. Means wound dehiscence comparison was statistically significant
CONCLUSION:
With particular emphasis on operating time, postoperative problems, hospital stay, and recurrence, the current study was created to compare the results of the two distinct approaches of pilonidal sinus surgical excision with primary closure and Limberg flap. While more research with a bigger volume sample and longer follow-up is required, we advise the Limberg flap approach for primary pilonidal illness due to its reduced morbidity rates compared to primary closure. Pilonidal sinus condition can be effectively treated with the Limberg flap technique.
KEYWORDS: Limberg flap, Pilonidal sinus, Visual analog scale, Direct suture, Surgical flaps