Limberg flap is better for the surgical treatment of pilonidal sinus. Results of a 767 patients series with an at least five years follow-up period.

PURPOSE: Pilonidal Sinus Disease (PSD) is an acquired condition usually seen in young adult males. This descriptive retrospective study has been performed to determine effects of primary suture, marsupialization and Limberg Flap for the management of PSD on the outcomes of return to work period, infection and recurrence rates.
METHODS: 823 patients were operated by same two surgeons, wide excision was done. Some patients were primarily closed (Group 1), some marsupialized (Group 2) and to a number of patients Classic Limberg (Rhomboid) Flap (Group 3) was applied. The type of the surgery was judged by the operating surgeon. In January 2010, 767 of 823 patients could be reached, and a planned telephone interview was done.
RESULTS: 767 patients (85 Female, 682 Male) with the median age of 25.8 were in the study. In "Return To Work (Days)" periods, there is statistically significant difference between groups (p < 0.001). The Return To Work Period is quite shorter in primary closure group compared with marsupialization group. In Limberg Flap Group the surgical site infection rate is the smallest with 4.7%. The highest recurrence rate is in the primary closure group. There is a statistically significant difference (p < 0.001) between the surgery types for the recurrence rates.
CONCLUSION: Because of earlier healing, shorter return to work and lower rates of infection and recurrence, limberg flap is better for PSD.