Rhomboid excision and Limberg flap for managing pilonidal sinus: results of 102 cases

PURPOSE: Although many methods of surgical and nonsurgical approaches for treatment of pilonidal sinus have been proposed, an optimal treatment modality has not been achieved yet. The aim of this study was to determine advantages, disadvantages, and long-term results of rhomboid excision and Limberg flap procedure. METHOD: One hundred ten patients who had been treated with rhomboid excision and Limberg flap procedure for primary or recurrent pilonidal sinus were invited to the hospital. One hundred two patients responded and were asked about their complaints and satisfaction with treatment. Physical examination was performed on each patient, and their hospital records were reviewed. RESULTS: Three patients developed seroma with negative bacterial cultures, two patients had partial wound dehiscence, and one patient had purulent discharge. Mean length of hospital stay was 3.7 days, and mean time to return to normal activity was seven days. Five patients developed recurrence (4.9 percent) and except for these patients, all of the patients were satisfied with the final result. CONCLUSION: Rhomboid excision and Limberg flap procedure can be performed for managing primary or recurrent pilonidal sinus with a low complication rate, short hospital stay, short time to return to normal activity, and good long-term results.