CLINICAL OUTCOMES OF LIMBERG FLAP CLOSURE FOLLOWING EXCISION OF PILONIDAL SINUS DISEASE: A CASE SERIES

Abstract

Background: Pilonidal sinus disease is a common chronic inflammatory condition affecting the sacrococcygeal region, predominantly in young adults. Conventional surgical techniques such as excision with open healing or primary midline closure are associated with prolonged wound care and higher recurrence rates. Limberg flap reconstruction has emerged as an effective alternative owing to its favorable healing profile and lower recurrence rates. Aim: To evaluate the clinical outcomes of Limberg flap reconstruction in patients undergoing surgical management for pilonidal sinus disease. Methods: This case series included 10 patients diagnosed with chronic pilonidal sinus disease who underwent rhomboid excision with Limberg flap reconstruction at a tertiary care center. Demographic characteristics, clinical presentation, operative findings, postoperative complications, duration of hospital stay, wound healing, and recurrence during follow-up were analyzed. Results: The study included 7 males and 3 females with a mean age of 23.5 years (range: 18–34 years). The duration of symptoms ranged from 6 to 15 months. Nine patients had primary disease, while one patient presented with recurrent pilonidal sinus following previous excision and healing by secondary intention. Multiple sinus tracts were identified in six patients. Primary wound healing was achieved in 9 patients (90%). One patient (10%) developed postoperative wound infection with mild wound dehiscence, which was managed successfully with conservative treatment. The mean hospital stay was 7.2 days (range: 5–14 days). During a mean follow-up period of 10.4 months, all patients achieved complete wound healing, and no recurrence was observed. Conclusion: Limberg flap reconstruction is a safe and effective surgical technique for the treatment of primary and recurrent pilonidal sinus disease. The procedure provides excellent wound healing, low postoperative morbidity, satisfactory cosmetic outcomes, and a low risk of recurrence. The findings of this case series support the use of Limberg flap reconstruction as a preferred surgical option over conventional excision techniques for chronic pilonidal sinus disease.