Modified Limberg's transposition flap for pilonidal sinus. Long term follow up of 216 cases.

AIM OF THIS STUDY to report our results in a large series of patients with chronic pilonidal sinus (PS) at long term follow up. MATERIALS AND METHODS Two hundred sixteen patients underwent excision and rhomboid flap transposition (RFT) from 1986 to 2004 for PS, and followed for more than two years. Clinical presentation includes: pilonidal abscess treated by drainage (33%), chronic discharge (48%) and simple infected sinus (19%). Mean follow-up was 74.4 months (range: 24-96). RESULTS Minimal flap necrosis occurred in 5 pts (2.3%), post operative infection in 2 pts (0.9%), 4 pts (1.8%) had a seroma, 18 pts (8.3%) anesthesia or hypoesthesia on the upper portion of the flap. The mean hospitalization was 3.1 +/- 0.30 days and return to work was 10.8 +/- 2.4 days. Recurrences occurred in 5 pts (7.4%) in our initial 87 pts. Since we modified the technique no recurrences were seen. CONCLUSIONS The Limberg's technique is a very effective procedure for chronic or recurrent PS with a low complications rate, a short hospital stay, a rapid return to normal activities and a low recurrence rate. Moreover with the modified technique the wound healing and the rate of recurrences have shown a significant decrease.