Background: Surgical treatment of sacrococcygeal pilonidal sinus is associated with significant recurrence rate.
However; recent studies suggested the use of rhomboid excision and Limberg flap repair as feasible procedure for
treatment of pilonidal sinus disease. Our aim is to evaluate the role of rhomboid excision of the pilonidal sinus with
Limberg flap by comparing this procedure with the traditional excision and primary closure.
Methods: This prospective study included 60 patients with sacrococcygeal pilonidal sinus. The patients were
randomly divided into 2 equal groups. Rhomboid excision of the sinus with limberg flap was performed in 30 patients
(group A), and excision of the sinus with primary closure was done to the other 30 cases (group B). Demographic data
and surgical outcome were compared between both groups.
Results: Group A showed significant early return to work and significant less postoperative pain than group B
(P=0.04 and P=0.02 respectively). Incidence of wound dehiscence, postoperative hematoma and seroma was less
among group A but without significant difference. The incidence of postoperative infection and recurrence rate was
significantly less in group A than group B (P=0.04 and P= 0.035 respectively).
Conclusion: Rhomboid excision and Limberg flap repair is an advantageous and effective modality than simple
excision with primary closure in treatment of sacrococcygeal disease. In addition, it is safe and easily procedure; it
may be an ideal treatment option in management of pilonidal sinus.