Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 1, January-February, p. 63–67

doi: 10.17219/acem/44483

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

The Dufourmentel modification of the limberg flap: Does it fit all?

Maciej Sebastian1,A,B,C,D,E,F, Maciej Sroczyński1,A,B,C,D,E,F, Jerzy Rudnicki1,A,B,C,D,E,F

1 Department of Minimally Invasive Surgery and Proctology, Wroclaw Medical University, Poland

Abstract

Background. Pilonidal disease is a common problem, especially in young adults. Therapy for the acute disease involves abscess incision and drainage. Treatment of the chronic disease is more complicated, due to the variety of methods and relatively high recurrence rate after surgical therapy.
Objectives. The aim of this study was to investigate the effects of the Dufourmentel modification of the Limberg flap in the treatment of pilonidal disease.
Material and Methods. The study involved 37 cases of chronic pilonidal disease that were operated on by the method presented. The group included 34 patients with primary disease and three patients with recurrences after primary excision.
Results. The complication rate in the study group was 8.1%, but the complications were successfully treated, surgically in one patient (using the same method) and non-surgically in two other patients. There were also two cases of temporary numbness in the operated area. The only disadvantage of the method presented may be the cosmetic results, but they were not the most important factor for the patients in the study.
Conclusion. The authors find the Dufourmentel modification of the Limberg flap superior to other methods of treating pilonidal disease due to its flexibility, simplicity of reconstruction, repeatability and good outcomes in terms of the recurrence rate. These factors are extremely important to young and active patients who are diagnosed with pilonidal disease.

Key words

recurrence, pilonidal disease, rhomboid flap

References (16)

  1. Shabbir J, Chaudhary BN, Britton DC. Management of sacrococcygeal pilonidal sinus disease: A snapshot of current practice. Int J Colorectal Dis. 2011;26:1619–1620.
  2. Yoldas T, Karaca C, Unalp O, et al. Recurrent pilonidal sinus: Lay open or flap closure, does it differ? Int Surg. 2013;98:319–323.
  3. De Parades V, Bouchard D, Janier M, Berger A. Pilonidal sinus disease. J Visc Surg. 2013;150:237–247.
  4. Enriquez-Navascues JM, Emparanza JI, Alkorta M, Placer C. Meta-analysis of randomized controlled trials comparing different techniques with primary closure for chronic pilonidal sinus. Tech Coloproctol. 2014;18:863–872.
  5. Khan PS, Hayat H, Hayat G. Limberg flap versus primary closure in the treatment of primary sacrococcygeal pilonidal disease: A randomized clinical trial. Indian J Surg. 2013;75:192–194.
  6. Park SS, Little S. Rhombic Flaps. In: Baker SR, ed. Local Flaps in Facial Reconstruction. Philadelphia: Elsevier Saunders.;2014:210–230.
  7. El-Khadrawy O, Hashish M, Ismail K, Shalaby H. Outcome of the rhomboid flap for recurrent pilonidal disease. World J Surg. 2009; 33:1064–1068.
  8. Altintoprak F, Gundogdu K, Ergonenc T, Dikicier E, Cakmak G, Celebi F. Retrospective review of pilonidal sinus patients with early discharge after Limberg flap procedure. Int Surg. 2014;99:28–34.
  9. Duman K, Ozdemir Y, Yucel E, Akin ML. Comparison of depression, anxiety and long-term quality of health in patients with a history of either primary closure or Limberg flap reconstruction for pilonidal sinus. Clinics (Sao Paulo). 2014;69,:384–387.
  10. Naveen N, Kumar MK, Babu KR, Dhanraj P. Tandem rhomboid flap repair: A new technique in treatment of extensive pilonidal disease of the natal cleft. J Clin Diagn Res. 2014;8,:3–4.
  11. Milone M, Di Minno MN, Bianco P, Coretti G, Musella M, Milone F. Pilonidal sinus surgery: Could we predict postoperative complications? Int Wound J. 2014. doi: 10.1111/iwj.12310.
  12. Alptekin H, Yilmaz H, Kayis SA, Sahin M. Volume of the excised specimen and prediction of surgical site infection in pilonidal sinus proce-dures (surgical site infection after pilonidal sinus surgery). Surg Today. 2013;43:1365–1370.
  13. Milone M, Di Minno MN, Musella M, Maietta P, et al. The role of drainage after excision and primary closure of pilonidal sinus: A meta-analysis. Tech Coloproctol. 2013;17:625–630.
  14. Afşarlar CE, Yılmaz E, Karaman A, et al. Treatment of adolescent pilonidal disease with a new modification to the Limberg flap: Symmetrically rotated rhomboid excision and lateralization of the Limberg flap technique. J Pediatr Surg. 2013;48:1744–1749.
  15. Petersen S, Koch R, Stelzner S, Wendlandt TP, Ludwig K. Primary closure techniques in chronic pilonidal sinus: A survey of the results of different surgical approaches. Dis Colon Rectum. 2002;45:1458–1467.
  16. Lieto E, Castellano P, Pinto M, Zamboli A, Pignatelli C, Galizia G. Dufourmentel rhomboid flap in the radical treatment of primary and recur-rent sacrococcygeal pilonidal disease. Dis Colon Rectum. 2010;53:1061–1068.
© Wroclaw Medical University