Publication:

Limberg flap as the standard treatment for pilonidal sinus

Pilonidal sinus disease (PSD) is a chronic inflammatory condition of the sacrococcygeal region predominantly affecting young adult males. Traditional surgical approaches such as wide excision with secondary healing or primary midline closure are associated with prolonged healing and higher recurrence rates. Off-midline flap procedures, particularly the Limberg flap, have demonstrated improved outcomes with faster recovery and lower recurrence. This retrospective case series included five male patients aged 20–30 years with chronic or recurrent PSD who underwent rhomboid excision with Limberg flap reconstruction between July 2023 and October 2024 at a district hospital. Operative details, postoperative outcomes, complications, and follow-up data were analyzed. The mean operative time was 45±15 minutes. Closed suction drains were removed on postoperative day 5±1. Two patients developed mild wound edge erythema that resolved with conservative treatment. No flap necrosis, wound infection, or seroma formation occurred. Complete wound healing was achieved within three weeks in all patients. During a follow-up period of 6–18 months, no recurrence was observed. Limberg flap reconstruction is a safe and effective technique for the treatment of pilonidal sinus disease, offering rapid wound healing, minimal complications, and low recurrence. Proper surgical technique and postoperative care are essential for optimal outcomes.