Treating Sacrococcygeal Pilonidal Sinus By Limberg Flap!

Sacrococcygeal Pilonidal Sinus is seen to mostly affect the male population. Though there is no certain explanation for the same, it is observed that it occurs in twenty-six people per lakh population. It affects men twice as often as women. Also, it is rarely seen before puberty and after forty years of age.

Sacrococcygeal Pilonidal Sinus is caused by three primary factors. They are the extreme force, high quantity of hair, and vulnerability to infection. A deep natal cleft also provides favorable environmental bacterial growth due to sweating, penetration of hair, sitting for long hours, and maceration. Thus, poor personal hygiene also leads to this condition. Implantation of hair causes infection and leads to a discharging sinus from abscess formation.

The main concern for the treatment of Sacrococcygeal Pilonidal Sinus is its recurrence. Regardless of the technique of management employed, the recurrence is observed to range between 20% and 40%. The reasons that are generally attributed to the recurrence of this condition are tracts left behind, sutures in midline causing more trauma and tension with repeated infection, accumulation of sweat, friction, and hair getting into the wound.

Limberg Rhomboid Flap is a surgical technique for the treatment of Sacrococcygeal Pilonidal Sinus. It was designed in 1946 by Limberg. He described the technique to close a 60 rhombus-shaped defect and transposition flap. The flap is easy to perform and sutures are being positioned away from the midline. It hence creates a tensionless flap in the middle of unscarred skin. It certainly helps in maintaining good hygiene, reducing maceration of sweat, reducing friction, skin erosion, and scar formation. The Limberg Flap method is superior to other flap procedures and to the primary closure as well. It is less complicated and has lower recurrence rates. This leads to shorter hospitalization, less post-operative pain, and earlier wound recovery than other methods.