Print ISSN: 2790-0207

Online ISSN: 2790-0215

Keywords : pilonidal sinus


Treatment of recurrent pilonidal sinus by flap technique (Limberg flap )

abdulkareem omer Mohamed salih

Kirkuk Journal of Medical Sciences, In Press

Background: pilonidal sinus(PNS) is a chronic disease that mostly affects young adults. describes a hair-filled cavity in the subcutaneous fat of the post sacral intergluteal region, known as the natal cleft , its name arises from the Latin terms “pilus” and “nidus” meaning a nest of hair PNS can be asymptomatic, or may be present as a recurrent abscess or as chronic inflamed cavity and local discharge from sinus or sinuses and local pain and discomfort .
retrospective study was done from (November 2017 to November 2018) at surgical department in Kirkuk General Hospital in 50 patients with recurrent PNS all will be treated with Limberg flap then follow up for one year this surgery done by excision of PNS till we reach fascia overlying sacrum inferiorly and laterally till we reach gluteal fascia and dissection was performed with electro cautery and reconstruction done by flap (Limberg flap) from gluteal area
in 50 patient with recurrent PNS we have 45 (90%) were male and 5 (10%) were female ,30 patient (60%) patients had a familial history of PNS and 42 patients(84%) with etiology-related risk factors to develop PNS then we divided them according first time surgery done either, by excision and primary closure 30 patient(60%) or excision and healing by granulation tissue and secondary intension 20patient (40%)

Treatment of recurrent pilonidal sinus by flap technique(Limberg flap)

Kirkuk Journal of Medical Sciences, 2022, Volume 10, Issue 1, Pages 34-43
DOI: 10.32894/kjms.2022.174184

Abstract
 
Background: pilonidal sinus (PNS) is a chronic disease that mostly affects young adults. describes a hair-filled cavity in the subcutaneous fat of the post sacral intergluteal region, known as the natal cleft , its name arises from the Latin terms “pilus” and “nidus” meaning  a nest of hair  PNS can be asymptomatic, or may be present  as a recurrent  abscess or as  chronic  inflamed cavity and local  discharge from sinus or sinuses and local pain and discomfort .
Materials and Methods: retrospective  study was done  from (November 2017 to November   2018) at surgical department in  Kirkuk General Hospital in 50 patients with  recurrent PNS all will be treated with  Limberg  flap then follow up for one year  this surgery done  by excision of PNS till  we reach  fascia overlying  sacrum inferiorly  and laterally till  we reach gluteal fascia and dissection was performed with electro cautery and  reconstruction done by  flap (Limberg flap) from gluteal area.
Results: in 50  patient  with recurrent PNS   we have 45 (90%) were male and 5 (10%) were female ,30 patient  (60%) patients had a familial history of PNS and 42 patients(84%) with etiology-related risk factors to develop PNS then  we divided them according first time surgery done either, by excision and primary closure 30 patient(60%) or excision and healing by granulation tissue and secondary intension 20patient (40%)
Discussion: pilonidal sinus not classified as  dangerous condition but any  patients  with PNS live in  non-comfortable   state and may have complications such as abscess formation   or discharging sinus even  severe  pain  therefore Limberg flap is  commonly used method to treat  recurrent PNS and this good  result with  healing in short period  also satisfactory results   in long duration but this method  with  Sacrococcygeal area  disfigure mentation  as one long duration complications  but   less  recurrence rates and  short stay in hospital and better patient  tolerability  in this way if we  compare it  to all other methods even  with  surgical challenge  to create a flap  but it less wound infection,  hematoma ,edema , wound separation  if we compare it  to  other surgical techniques but fluid accumulation in close space under flap is one of important complications in this method and we decrease it   by  using a  drain  and putted  in site until fluid drainage in area  decreased to be less than 50 ml/day .
In this method recurrence rate in our study is 2%  but  reported recurrence rate for Limberg flap are from 0.8 to 2.7% if we compare to 12% recurrent rate   in  primary closure therefore we have very good recurrence rate
Conclusions: the approach for recurrent PNS should be differ  from  primary PNS flap reconstruction methods in treatment for recurrent PNS  is very good  and efficient method even with surgical challenge procedure  to create flap, personal hygiene are the keystones for preventing recurrence

Comparison of Primary Midline Closure and Open Surgery for Sacrococcygeal Pilonidal Sinus: A Retrospective Study

Fadhluddin Nasruddin Shakor; Deari Ahmed Ismaeil; Sarmad Hiwa Arif; Ary Hama Saeed

Kirkuk Journal of Medical Sciences, 2019, Volume 7, Issue 1, Pages 44-52
DOI: 10.32894/kjms.2021.169389

Background: Sacrococcygeal Pilonidal sinus (SPNS) isa common problem has a variable presentation and many surgical techniques for treatment. Still, there is controversy about the best method of surgery, because of notable rates of recurrence. Objective: The aim is to clarify the better, cost-effective and less painful method for treating patients having SPNS. Methods: This is a retrospective study of 119 patients with SPNS, treated by two different surgical methods: group A (69 patients) treated with open surgery and group B (50 patients) treated by primary midline closure. The patients followed for 2 years. Comparison between the two groups was done, for post-operative complications and recurrence. The data were analyzed using of Statistical Package for Social Science (SPSS) version 21. Chi square used to determine association between variables. P value < 0.05 is regarded statistically significant. Results: From 119 patients: Group A (69 cases) underwent open surgery and group B (50 cases) had primary closure. Postoperative infection was (5.9%), bleeding (2.5%), scar fissuring (5.9%) and chronic pain (3.4%). Recurrence found in 6 patients (5%); 2(2.9%) in Group A and 4(8%) in Group B. Conclusions: The open method needs multiple dressings which are coasty and painful, longer healing time and may be complicated by scar fissuring, but of lower recurrent and infection. The closed method is preferablefor patient's comfort, and it is costeffectiveness.