Document Type : Original research
Authors
1 General Surgeon, FICMS, CABS. Department of Surgery, Kirkuk General Hospital. Iraq
2 General Surgeon, FICMS. Department of Surgery, Kirkuk General Hospital. Iraq
Abstract
Background: Pilonidal sinus (PNS) is a chronic condition affecting mainly young adults, characterized by a hair-containing cavity in the post-sacral intergluteal (natal cleft) region. It may be asymptomatic or present as a recurrent abscess or a chronically inflamed, discharging sinus with local pain and discomfort.
Methods: This retrospective study was conducted from November 2017 to November 2018 at the Department of Surgery, Kirkuk General Hospital. Fifty patients with recurrent PNS were treated using the Limberg flap technique. Excision was performed down to the sacral fascia and laterally to the gluteal fascia, followed by reconstruction using a gluteal-based Limberg flap. Patients were followed up for one year.
Result: Of the 50 patients, 45 (90%) were male and 5 (10%) female. A positive family history was found in 60%, and 84% had risk factors for PNS. Thirty patients (60%) had previously undergone excision with primary closure, and 20 (40%) had healing by secondary intention. The recurrence rate following Limberg flap was 2%, which is lower than the 12% rate reported with primary closure. Common complications included fluid accumulation under the flap, managed by placing a drain until drainage fell below 50 mL/day.
Conclusions: The Limberg flap technique is an effective treatment for recurrent PNS, offering low recurrence rates, fewer complications, shorter hospital stays, and good patient satisfaction. While technically demanding, it outperforms conventional methods. Personal hygiene remains essential in preventing recurrence.
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