Clinical trial comparing excision and primary closure with modified Limberg flap in the treatment of uncomplicated sacrococcygeal pilonidal disease

The aim of this study was to compare modified Limberg flap procedure with excision and primary closure in the treatment of uncomplicated pilonidal disease. Methods: This study was conducted on 120 patients with uncomplicated sacrococcygeal pilonidal disease that were randomly allocated into two groups: group I underwent excision and primary closure; group II underwent modified Limberg flap procedure. The duration of operation, postoperative pain, length of hospital stay, duration of incapacity for work, postoperative complications and postoperative recurrence were recorded. Results: Duration of operation was longer in group II than in group 1 (P 0.001). However, postoperative pain was less (P 0.001), duration of hospital stay shorter (P 0.001), time to resumption of work shorter (P 0.001) and postoperative complications were significantly fewer in group II. During follow-up period of 21.5 ± 6.82 (months) for group I and 22 ± 7.64 (months) for group II, single case of recurrence 1.67% was detected in patients in group II versus four patients (6.67% patients) in group I (P =0.032). Conclusion: Wide excision with a modified Limberg transposition flap reconstruction is a very effective operative procedure for uncomplicated pilonidal sinus, associated with a low complication rate, short hospitalization and disability, and a low recurrence rate.