Comparison between primary closure with Limberg Flap versus open procedure in treatment of pilonidal sinus, in terms of frequency of post-operative wound infection

Objective: Pilonidal sinus is a disorder of the sacrococcygeal region affecting younger individuals with a higher hair and weight distribution. Treatment involves the use of various surgical modalities, most of which are associated with a high rate of complications. Open procedure (OP) and Limberg Flap (LF) are two commonly performed surgical procedures for the correction of pilonidal sinus disease in our setup. The objective of our study was to compare the treatment of pilonidal sinus disease by primary closure with Limberg Flap verses Open procedure in terms of frequency of postoperative wound infection.

Methods: The study is a randomized clinical trial (RCT) conducted at the department of surgery, military hospital, Rawalpindi, Pakistan. It was carried out over a period of 8 months from 16 February, 2015 to 16 September, 2015. Using consecutive non-probability sampling, a total of 60 patients were selected, 30 of whom underwent Limberg Flap procedure and the remaining 30 underwent open procedure. Postoperatively, observations for wound infection on date of discharge and then again on the various follow-up visits over the next 3 weeks. The data collected was then compared by applying the chi-square test, with p-value less than 0.05 considered statistically significant.

Results: Our results showed that both primary closure with Limberg flap, and open procedure are comparable options in terms of wound infection. There was no statistical significance in the incidence of post operative infections, between the two surgeries.

Conclusion: In terms of wound infection, both procedures are satisfactory surgical procedures for Pilonidal sinus disease.