BACKGROUND: Surgical treatment for pilonidal sinus disease is associated with significant morbidity and some recurrence rates. The rhomboid flap of Limberg is a transposition flap which has been advocated since the year 1946 for the surgical treatment of this condition. The gold standard treatment of recurrent pilonidal disease still remains elusive. As far as the patient is concerned the main concern for surgical treatment of this disease is recurrence. An old article (1995) mentions it to range from 20–40 % regardless of the technique used. The main aim of this long term follow up is specifically that. METHODS: This is a retrospective , observational, single centre study carried out at a tertiary care centre, with the study period extending from January 2015 to January 2021 with a sample size of 103 patients. AIMS: 1. Long term follow up (mean of 3.75 yrs ) of patients who underwent Limberg’s flap repair for primary pilonidal sinus and primary with secondary tracts to estimate recurrence rates. 2. To assess the complication rate following Limberg’s flap for the above condition. RESULTS: After a mean follow up of 3.75 years , a recurrence rate of 16.5% was noted in patients undergoing Limberg’s flap. The total complication rate excluding recurrence was 29.1%.which include -12.6% of infected collection, 8.7% of seroma formation, 1.9% of hematoma, 3.8% of wound dehiscence and 1.9% of flap necrosis occurrence. In the final analysis, the following reasons for recurrence were observed. 64.7% was due to secondary infection and in 17.6% no root cause was found. In the approach for treatment of complications , three different methods were employed. 1. The debridement with or without Vacuum-Assisted Closure (VAC) device followed by secondary suturing utilized in 7 patients (41.1%). 2. Excision with Z-plasty was performed in 6 patients (35.2%), 3. Alternative medicine was opted by 4 patients (26.6%). CONCLUSION: In the light of these results in the retrospective analysis, Limberg flap as a surgical technique for pilonidal sinus disease may not be a gold standard.
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