Background: There are controversies
about the etiology and management of recurrent pilonidal sinus. The numbers of
techniques are testament in treating pilonidal sinus (PNS) and no single
procedure is superior in all aspects. Aim of the study: The aim of this study was to
compare two operative procedures (modified Limberg flap versus Z plasty flap)
in management of recurrent pilonidal sinus, regarding their complications
including recurrences of the disease, morbidity, hospital stay, day off work
and postoperative complications. Patients and methods:This is comparative
prospective study between modified Limberg flap and Z plasty flap in treatment
of recurrent pilonidal sinus. 30 patients were divided into 2 groups: Group (1)
treated with modified Limberg flap and group (2) treated with Z plasty, and we
followed up the patients in both groups for postoperative complications,
hospital stay, day off work, recurrences, patients satisfactions. Results:Operative time, hospital
stay duration, complete wound healing was longer in group (2) Z plasty group.
Mobilization was early in MLF group than Z plasty group (1 day versus 2 days).
Time to return to work, it was 14 (12 - 16) days in MLF groups and
18 (15 - 22) in Z plasty group (p
< 0.001).
Infection occurred only in one in MLF group (1) and 2 patients in Z plasty
group (2). The
mean time for complete healing of the wound after Modified Limberg flap group
(1) was 16 ±
4.2 days while in Z plasty group (2) it was 22 ± 6.8 days.
Satisfaction score was better
in MLF group (1). Recurrence hadn’t occurred in any of the patients included in
this study during the follow-up period. Conclusion: Both of modified Limberg flap and
Z-plasty technique are used to cause flattening of the natal cleft, thus
reducing local recurrence rates. So, we recommend use of flap technique for
recurrent pilonidal sinus patients; modified Limberg transposition flap is
better than Z plasty flap, because of the less hospital stay time, early return
to work, and cosmetically more accepted as it has less postoperative
complications. Also Z plasty flap has a major limitation as it is difficult to
apply if there is a wide defect in the horizontal axis.
Cite this paper
R., A. G. , A., M. Y. , Mohamed, M. A. S. , Saleem, A. A. , Abdallah, H. A. and Husein, H. M. (2018). A Modified Limberg Flap versus Z Plasty Flap Technique in Management of Recurrent Pilonidal Disease: A Comparative Prospective Study. Open Access Library Journal, 5, e4715. doi: http://dx.doi.org/10.4236/oalib.1104715.
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