[Long-term results of a pilot study on a two-stage procedure with primary excision and Limberg flap in the interval for treatment of sacrococcygeal pilonidal sinus disease].

Background: The current Association of the Scientific Medical Societies in Germany (AWMF) S3 guidelines recommend among others a Limberg flap for the treatment of pilonidal sinus disease. This article reports the long-term results of the pilot study: "Results of a two-stage intervention with primary excision and Limberg flap in the interval for treatment of sacrococcygeal pilonidal sinus disease", published in 2015.

Method: From 2010 to 2013 a total of 50 patients with sacrococcygeal pilonidal sinus disease were treated. Following initial excision patients were offered plastic coverage in the presence of clean wound conditions according to the then relevant AWMF guidelines in primary cases and recommended in recurrent cases. Of the patients 22 opted for a Limberg flap. In 2022 recurrences were recorded via telephone interviews with patients. The groups with a Limberg flap were compared with the excision group.

Results: There were no recurrences in the Limberg flap group (0%) while there were six recurrences in the excision group (23%) p = 0.028. In the Limberg group one patient and in the excision group two patients were lost to follow-up.

Conclusion: With a two-stage technique a Limberg flap is obviously more effective under inflammation-free wound conditions. The Limberg flap is a simple plastic surgery procedure; however, one should remember that it is a transposition flap.