Comparing Square Excision and Transposition Flap Versus Modified Limberg Flap in Sacrococcygeal Pilonidal Sinus Disease Surgery: A New Technique With Fewer Wound Issues.

Abstract:

Objective: Pilonidal sinus disease (PSD) is a common disease that is an important health problem. Using new flap methods in defect closure in PSD surgery may be useful in obtaining ideal surgical outcomes. This study aimed to present the early outcomes of the square excision and transposition flap (SF) technique compared with the modified Limberg flap (LF).

Methods: Patients who underwent surgical intervention for PSD utilizing SF and LF techniques between January 2016 and January 2022 were evaluated. Demographics, comorbidity, clinical presentation, pain assessment, hospital stay duration, healing time, time to return to work, and recurrence status were compared between the SF and LF groups.

Results: There was no significant difference between the SF (53 patients) and LF (49 patients) groups regarding demographic and most clinical characteristics. Patients in the SF group experienced shorter healing times of 11 days and quicker returns to work at 13 days compared with patients in the LF group (P<.001). A lower incidence of wound infection was observed in the SF group (3.8%) compared with the LF group (16.3%) (P=.035). Partial wound dehiscence was more observed in the LF group (18.4%), marking a significant difference (P=.001). Regarding cosmetic satisfaction at the 6-month follow-up, the SF group reported higher satisfaction rates. The SF group had a lower recurrence rate.

Conclusions: The SF method had lower wound dehiscence, shorter healing time, and shorter return-to-work time compared with the modified LF. Patients have more cosmetic satisfaction. The SF technique can be considered as an option in the surgical treatment of PSD.