Gulab Dhar Yadav1, Ashish Varshney2, Adiveeth Deb3
BACKGROUND
Sacrococcygeal pilonidal sinus disease is defined as a hair-filled cavity in the
subcutaneous fat of the natal cleft (postsacral intergluteal region). This study was
done to investigate the prevalence, clinical presentation, body mass index (BMI)
as a risk factor; and complications of Limberg flap and Z-plasty, for the
reconstruction of defects after excision of sacrococcygeal pilonidal sinus in terms
of the incidence of seroma, wound infection, wound dehiscence, flap necrosis,
recurrence, duration of hospital stay and time taken for complete wound healing
after the procedure.
METHODS
This was a prospective study done on 50 patients from January 2018 to October
2020 at a tertiary care hospital in 15 to 50 years of age group presenting with
pilonidal sinus disease.
Statistical analysis was done using SPSS (Statistical Package for Social Sciences)
version 15.0 statistical analysis software. Significance was assessed at 5 %.
RESULTS
The mean age of presentation was 25 years with chief complains of swelling,
discharge and pain, the mean BMI was 24.39 kg/m2. Anaerobic infection is more
common in the sinus (40 %), and among aerobic organisms, Staphylococcus was
the most common organism (19 %). In Limberg flap closure, only one 1 developed
wound infection and this same patient had partial wound dehiscence, while in Zplasty
group, 3 developed seroma, 2 wound infections and 2 partial flap ischemia.
CONCLUSIONS
The goals of management of pilonidal sinus diseases include conservative
management along with definitive surgical treatment of the disease. Pilonidal
abscess is managed by incision and drainage and is followed by definitive
treatment, later on. Flap procedures are effective ways to treat the disease, of
which Limberg flap is the most reliable flap with minimum complications, lesser
hospital stay and faster wound healing.
