scholarly journals The effects of perioperative antibiotherapy on surgical site infections in sacrococcygeal pilonidal sinus treated with rhomboid excision and Limberg transposition procedure

2019 ◽  
Author(s):  
Hasan Calis ◽  
Yilmaz Guler ◽  
Serkan Sengul ◽  
Zulfikar Karabulut
Keyword(s):  
Pilonidal Sinus ◽  
Surgical Site Infections ◽  
Rhomboid Excision

Rhomboid excision and Limberg flap operation for managing pilonidal sinus: our experience at Patan Hospital, Patan Academy of Health Sciences

2019 ◽  
Vol 22 (1) ◽  
pp. 7-11
Author(s):  
Sanjaya Paudyal ◽  
Shanta Bir Maharjan ◽  
Niraj Giri ◽  
Samayukta K.C.
Keyword(s):  
Pilonidal Sinus ◽  
Surgical Techniques ◽  
Surgical Site Infections ◽  
Health Sciences ◽  
Common Disease ◽  
Limberg Flap ◽  
Flap Reconstruction ◽  
Natal Cleft ◽  
The Mean ◽  
Rhomboid Excision

Introduction: Pilonidal sinus is a common disease. Various surgical techniques for management of sacrococcygeal pilonidal sinus have been described. Among them, the most commonly used is the rhomboid excision with the Limberg flap. With this technique of flattening the natal cleft and tension-free repair is made using a wide, well-vascularized flap. It is reported the best treatment methods, with 0-16 % of surgical area-related complications and a recurrence rate of 0-5 %. We conducted a study to evaluate the patient’s profile and outcomes of the patients of pilonidal sinus treated with rhomboid excision and Limberg flap reconstruction at our center. Methods: Data were recorded retrospectively by reviewing the charts of patients who underwent rhomboid excision and Limberg flap operation for sacrococcygeal pilonidal sinus from September 2015 to September 2019. Results: Thirty-four patients were included in the study. Twenty-nine (85.4%) were males and 5 (14.7%) were females. The mean age was 25.29 years (range 17-40 years). Mean hospital stay was 4.5 days (range 3 – 7 days. Nine (26.5%) patients had surgical site infections. Two patients (5.9%) had a recurrence. Conclusion: Limberg flap for reconstruction after rhomboid excision of pilonidal sinus is an effective and feasible technique with good outcome.  

Compare outcome of simple excision with primary closure vs rhomboid excision with limberg flap for pilonidal sinus

2021 ◽  
pp. 2920-2922
Author(s):  
M. Kaleem ◽  
F. Mubarik ◽  
M. U. Afzal ◽  
A. Zahid ◽  
W. I. Andrabi ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Advancement Flap ◽  
Pilonidal Sinus Disease ◽  
P Value ◽  
Limberg Flap ◽  
Simple Excision ◽  
Group A ◽  
Group B ◽  
Rhomboid Excision

Background: Sacrococcygeal pilonidal sinus is a common condition usually affecting young-to-middle-aged men. For managing sacrococcygeal pilonidal illness, a variety of lateralizing surgical flap procedures based on this principle have been published, including the Karydakis flap, Limberg flap, modified Limberg flap, Z-plasty, and Y-V advancement flap. Aim: To compare the outcome of simple excision with primary closure versus rhomboid excision with limberg flap for sacrococcygeal pilonidal sinus. Methodology: Randomized control study conducted in Surgery Department, Ghurki Trust Hospital, Lahore. 90 patients fulfilling the inclusion criteria were selected from wards and were randomly divided in two equal groups. In group A, patients underwent rhomboid excision with limberg flap. In group B, patients underwent simple excision with primary closure. The operation was performed under spinal anesthesia. After surgery, patients were evaluated every 24 hours if they are able to move on their own then they were discharged and hospital stay was noted. Then after 10 days, patients will be called in OPD for assessment of wound healing. If wound did heal and patient complained of pain (VAS>4) and cannot sit and have fever (temp>100oF) Results: The average age in group A was 44.37±15.42 years while that in group B was 45.24±14.50 years. In group A there were 23(51.1%) males and 22 (48.9%) females whereas in group B there were 25(55.6%) males and 20(44.4%) females. There was difference significant in the mean stay in hospital in both groups (p-value=0.002). Conclusion: The conclusion of the study, that primary sacrococcygeal pilonidal sinus disease and rhomboid excision with Limberg's flap is an effective treatment. Keywords: Simple Excision with Primary Closure, Rhomboid Excision, Limberg Flap, Sacrococcygeal Pilonidal Sinus

Day-Case Limberg Flap for Recurrent Pilonidal Sinus: Does Obesity Complicate the Issue?

2010 ◽  
Vol 76 (9) ◽  
pp. 995-999 ◽  
Author(s):  
Khaled M. Madbouly
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Operative Time ◽  
Day Surgery ◽  
Complete Healing ◽  
Limberg Flap ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Rhomboid Excision

The purpose of this study was to analyze the long-term outcome of rhomboid excision with Limberg flap reconstruction (LF) as one-day surgery in treatment of recurrent pilonidal sinus (RPS). The effect of obesity on outcome will be addressed. Forty-nine patients with RPS were treated by rhomboid excision and LF as one-day surgery. Data collected included demographics, body mass index, operative time, flap ischemia, wound infection, length of hospital stay, time of complete healing, and recurrence. Patients’ mean age was 33.4 years and mean number of previous operations was 3.4. Operative time ranged from 40 to 70 minutes. Two patients developed sterile seroma (4.1%) and two patients (4.1%) had wound infections. No wound dehiscence or flap ischemia was reported. All patients returned to normal activity within 7 days. No recurrences were reported after a mean follow-up of 32.1 months. Obesity significantly increased the operative time, however, it affected neither the postoperative outcome nor the long-term recurrence. Rhomboid excision and LF as one-day surgery is a safe and reliable method for treatment of RPS. It guarantees low morbidity, short hospital stay, short time off work, and carries low risk of recurrence, even in obese patients.

Rhomboid Excision and Limberg Flap for Managing Pilonidal Sinus

2002 ◽  
Vol 45 (5) ◽  
pp. 656-659 ◽  
Author(s):  
Mustafa Kemal Urhan ◽  
Fikri Kücükel ◽  
Koray Topgul ◽  
İlter Özer ◽  
Seckin Sari
Keyword(s):  
Pilonidal Sinus ◽  
Limberg Flap ◽  
Rhomboid Excision

Modified Limberg Flap Cover for Recurrent Sacrococcygeal Pilonidal Sinus: Our Experience at a Medical College In Nepal

2021 ◽  
Vol 6 (1) ◽  
pp. 1274-1279
Author(s):  
Budhi Nath Adhikari ◽  
Abhishek Bhattarai ◽  
Pragya Devkota ◽  
Sushma Khatiwada
Keyword(s):  
Patient Satisfaction ◽  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Limberg Flap ◽  
Recurrence Rates ◽  
Transposition Flap ◽  
Young Males ◽  
Modified Limberg Flap ◽  
The Mean ◽  
Rhomboid Excision

Introduction: Pilonidal sinus is an inflammatory disease seen mostly in the intergluteal region of young males. Although any treatment strategy of this condition is generally free of life-threatening complications due to its superficial nature, it is still a feared disease because of recurrence which greatly increases the morbidity. Objective: To investigate the results of wide rhomboid excision and modified Limberg transposition flap reconstruction to treat recurrent pilonidal sinus. Methodology: Well-documented records of all patients with recurrent sacrococcygeal pilonidal sinus who underwent wide excision and a modified Limberg transposition flap at our center during the past 3 years and followed up for longer than 12 months were analyzed. The modification primarily consisted of an asymmetrically rotated rhomboid excision and lateralization of the lower midline. Patient demographics, days of hospitalization, complications, patient satisfaction and recurrence rates were evaluated. Result: Most patients in the study were overweight. No relationship was detected between BMI and number of sinus openings, hospital stay, drain placement or recurrences but an association with infection was noted. The number of pilonidal sinus orifices did not have a correlation with age, number of previous surgeries, duration of hospital stay or drains placement. The mean duration of hospitalization was 7.89 ± 3.41 days and the mean duration of suction drainage was 6.33±2.87 days. Half of our patients developed complications in the postoperative period. The only patient who developed superficial wound infection stayed the most in the hospital. All patients had some complaints regarding the operation site; however, they were satisfied with the result of the operation and had no recurrence at 12 months of follow-up. Conclusion: Rhomboid excision of recurrent sacrococcygeal pilonidal sinus with modified Limberg flap closure is a promising surgical technique with advantages of a good patient satisfaction and no recurrence after a year of surgery.

scholarly journals Prospective randomized study of surgical treatment of pilonidal sinus; primary midline closure after elliptical excision versus rhomboid excision with limberg flap reconstruction versus open excision and healing by secondary intention

2017 ◽  
Vol 4 (11) ◽  
pp. 3646
Author(s):  
Rajneesh Kumar ◽  
Ankur Hastir ◽  
Ramandeep S. Walia ◽  
Subhash Goyal ◽  
Amandeep Kaur
Keyword(s):  
Surgical Treatment ◽  
Pilonidal Sinus ◽  
Healing Time ◽  
Limberg Flap ◽  
Flap Reconstruction ◽  
Group I ◽  
Group Ii ◽  
Open Excision ◽  
Midline Closure ◽  
Rhomboid Excision

Background: Best surgical treatment of pilonidal sinus is always challenging for a surgeon in term of recurrence. Evaluation of surgical treatment of pilonidal sinus; primary midline closure after elliptical excision versus rhomboid excision with limberg flap reconstruction versus open excision and healing by secondary intention of sacrococcygeal pilonidal disease.Methods: In this prospective randomized study of 75 patients of sacrococcygeal pilonidal sinus were divided into 3 equal groups through randomly assigning the type of surgery. 25 patients of each group. Group I was operated by primary midline closure after elliptical excision, Group II rhomboid excision with limberg flap reconstruction and Group III open excision and healing by secondary intention.Results: Data was assessed between three groups in term of operative time, healing time and recurrence over a follow up period of 1 year. Mean operative time in group I (primary midline closure after elliptical excision) was 38.7±5.1 minutes, group II (Rhomboid excision with Limberg flap reconstruction) was 124.2±5.6 minutes, group III (Open excision and healing by secondary intention) was 20.6±5.6 minutes. Mean healing time for group I was 19.0±7.4 days, for group II was 17.0±8.0 days and for group III was 60±9.6 days. Recurrence occurred in 3 patients in group I and nil in group II and III.Conclusions: Rhomboid excision with limberg flap reconstruction is better choice than primary midline closure after elliptical excision and open excision in terms of healing time and reoccurrence in cases of sacrococcygeal pilonidal sinus.

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