Limberg Flap Procedure for Sacrococcygeal Pilonidal Sinus Disease

Abstract

Background: Sacrococcygeal pilonidal sinus disease is a common morbid disease with high recurrence rate after surgery. Many surgical procedures have been described with their merits and demerits. Objectives: To evaluate the efficacy and complications of Limberg flap reconstructive technique in the management of pilonidal sinus disease with multiple openings and tracts. Methods: Seventy eight consecutive patients with complex pilonidal sinus disease underwent Limberg flap reconstruction between March 2022 and March 2025. Results: The local postoperative complications were flap edema in nine patients, seroma in eight, flap necrosis in five and local wound sepsis in ten. These minor local complications nearly took 1-3 weeks to heal with regular dressings and antibiotic usage. Four patients develop wound dehiscence and took nearly six weeks for healing by secondary intention. Three patients developed recurrence at median follow-up of 22 months. Conclusions: Limberg flap procedure after excision of complex sacrococcygeal pilonidal sinus disease is an effective and reliable procedure for both primary and recurrent pilonidal sinus disease with acceptable rate of complications.