Comparison of outcome of open excision with secondary healing versus rhomboid excision with limberg transposition flap in the management of sacrococcygeal pilonidal disease

Aim: to compare the outcome of open excision and secondary healing with rhomboid excision and limberg flap in the management of sacrococcygeal pilonidal sinus disease (spd). study design: prospective,analytical,comparative study place & duration of study: deptt. of surgery,kemu/mayo hospital,from june 2014 to dec. 2014. methods: in this prospective,analytical,comparative study using randomized controlled trial (rct) total 49 patients,who either underwent open excision and secondary healing (group a: 25 patients) or rhomboid excision and limberg flap (group b: 24 patients),were enrolled in the study. duration of operation,postoperative pain,hospital stay,postoperative complications,and time to recurrence were noted. the inclusion criteria were all patients with primary or recurrent spd. the exclusion criteria were: cases with incomplete data and those lost to follow-up. results: duration of operation was longer in group b patients (p=0.004) but pain perception was markedly reduced in this group (p=0.003). total hospitalization period was shorter in patients in group b (p=0.002) and so was the time for complete healing of the wound (p=0.002). the recurrence rate was also significantly lower in patients who underwent limberg rotation flap (p=0.005). conclusion: limberg flap is advantageous over simple excision and secondary healing in the management of spd .patients who were lost to follow-up. an informed consent was taken and patients were counseled about the merits and demerits of both the procedures. duration of operation,postoperative pain,duration of hospital stay,postoperative complications,and time to recurrence were noted. conclusion: despite of longer operative time and demanding surgical skills,limberg flap due to its low rates of recurrence and comparatively few complications is preferable over simple excision and secondary healing in the management of sacrococcygeal pilonidal sinus.