Comparison of cleft lift and limberg flap techniques for pilonidal sinus surgery

Abstract

Sacrococcygeal pilonidal disease is an infection and also chronic inflammation of the sacral region which has been generally seen in young patient population. Though, numerous surgical techniques have been described in the medical literature, a recent Cochrane review shows that the resection with an off-midline close technique should be chosen to conventional primary midline closure due to its advantages including lower recurrence rates and faster wound healing. The aim of this study was to compare the outcomes of the Cleft-lift (CL) versus Limberg-flap (LF) techniques. Between 2007 and 2009, a total of 131 patients with sacrococcygeal pilonidal disease were randomized into two study groups regarding the operative technique of CL [Group-1 (G1)] and LF [Group-2 (G2)]. Patients with prior abscess drainage were excluded from the study. Groups were compared regarding the recurrence, operation time, duration of hospital stay and other morbidities. Data were collected retrospectively from patients charts and department database. There were 60 patients in group 1 and 71 patients in group 2. The mean age of the patients was 20.2 years (16-33). The mean operative time of group 1 (43.2 ± 7.9 minutes) was significantly shorter than group 2 (52.6±8.6 minutes) (p<0.01). There were no significant differences between study groups regarding hospital stay, wound infection and recurrences. In conclusion, CL procedure was found to be as effective as the LF technique due to advantage of shorter operative time and similar safety outcomes.