Bascom’s cleft lift versus rhomboid flap procedure for the management of primary sacrococcygeal pilonidal sinus

Objective: The aim of this study was to evaluate and compare clinical safety and effi cacy after Bascom’s cleft lift and rhomboid flap (Limberg) procedures for the treatment of primary sacrococcygeal pilonidal sinus ( SCPS). Patients and methods: This study included 100 adult patients with primary (nonrecurrent) SCPS who were randomized to Bascom’s cleft lift procedure (n = 50) or to rhomboid flap procedure (rhomboid-shaped excision and Limberg fl ap) (n = 50). Through the follow-up period, which ranged from 6 to 12 months, with an average of 9.1 ± 1.7 months, patients were evaluated for wound-related complications and recurrence of symptoms after complete wound healing. Results: There were insignificant differences in the baseline characteristics between both groups. Compared with Bascom’s cleft lift procedure, the rhomboid flap procedure involved a longer duration of operation (61.14 ± 16.36 vs. 40.78 ± 11.96 min; P 0.001). A significant clinical outcome was achieved after the rhomboid flap procedure in terms of less duration to pain relief (12.42 ± 1.59 vs. 17.86 ± 3.10; P 0.001) and less healing time (17.42 ± 4.68 vs. 20.06 ± 5.94; P 0.05). The incidences of postoperative wound-related complications and recurrence were 6 and 2%, respectively, after the Bascom’s cleft lift procedure and 4 and 2%, respectively, after the rhomboid flap procedure, with insignificant differences. Conclusion: Although Bascom’s cleft lift operation involves a shorter duration of operation, the rhomboid shaped excision with the Limberg flap procedure was superior in terms of early wound healing, with similar incidences of wound-related complications and recurrence after treatment of primary SCPS.