• Ahmet Okuş, Bariş Sevinç, Omer Karahan, and Mehmet A Eryilmaz.
• Department of General Surgery, Konya Education and Research Hospital, Konya, Turkey.
• World J Surg. 2012 Feb 1;36(2):431-5.

BackgroundPilonidal disease is an inflammatory disease seen in the intergluteal region. In this study, our aim was to compare the efficacy of the Limberg flap versus a tension-free primary closure.MethodsA total of 93 patients were included in this study. The patients were assigned consecutively by the closed-envelope technique to one of two groups: 49 patients in group 1 (excision and Limberg flap) and 44 patients in group 2 (tension-free primary closure). Excision and reconstruction with the Limberg flap was performed in its classic form. For tension-free primary closure after excision of the sinus tract with an elliptical incision, the skin and subcutaneous tissue were released 2-3 cm away from the incision line. The subcutaneous tissue was closed twofold with 2/0 polyglactin sutures. The skin underwent 3/0 polypropylene mattress suturing.ResultsThe median age was 25 years (17-43 years). The median follow-up period was 29.5 months (8-43 months). There was no significant difference between the groups in terms of age, sex, follow-up time, or anesthesia method. One patient in each group experienced wound infection. During the first 6 months of follow-up there was no recurrence. However, at later visits recurrences were seen in two patients in each group (4.1% in group 1, 4.5% in group 2).ConclusionsThe lower rates of wound infection and recurrence associated with the Limberg flap reported elsewhere may be associated with healing of the tension-free procedure. In this study, tension-free primary closure was found to be as effective as the Limberg flap reconstruction.

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