Comparison of depression, anxiety and long-term quality of health in patients with a history of either primary closure or Limberg flap reconstruction for pilonidal sinus

OBJECTIVE Pilonidal sinus is characterized by high operative morbidity mainly due to wound problems. We aimed to compare the quality of health, comfort and psychological status in patients who underwent surgery for pilonidal sinus. METHODS A total of 205 pilonidal sinus patients operated on with either primary closure or Limberg flap reconstruction were compared in terms of depression, anxiety, and long-term quality of health by using Short Form 36, Beck Depression Inventory, and Beck Anxiety Inventory scales. RESULTS There were 107 patients in the primary closure group with a mean follow-up of 29.6 ± 7.7 months and 98 patients in the Limberg flap group with a mean follow-up of 34.1 ± 7.3 months. In the SF-36 analysis, the mental health and bodily pain scores (59 ± 6 and 56 ± 11 in the primary closure group and 62 ± 8 and 61 ± 10 in the Limberg flap group) were significantly higher in the Limberg flap group (p = 0.014 and p = 0.002, respectively). The mean Beck Depression Inventory (19 ± 6.13 vs. 16 ± 4.90 p<0.001) and Beck Anxiety Inventory (19 ± 6.27 vs. 16 ± 4.90 p<0.001) scores were lower in the Limberg flap group. CONCLUSION Limberg flap reconstruction produced better quality of health scores according to the SF 36, especially in terms of mental health and bodily pain. There was a higher tendency towards anxiety and depression in the primary closure group.