Navarethina Rajan, A (2020) Comparative study between Excision with Primary Closure Versus Limberg Flap in the Management of Sacrococcygeal Pilonidal Sinus. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
BACKGROUND: Pilonidal sinus is a disease of young adult males. Although there are various hypothesis introduced for the disease, acquired theory is the most widely accepted. Management of the disease is complex because of higher incidence of post op infection, recurrence and poor wound healing. AIM AND OBJECTIVES: Our aim of this study is to compare the Rhomboid excision with Limberg flap versus Excision with primary closure in the treatment of uncomplicated sacrococcygeal pilonidal sinus disease in terms of morbidity, hospital stay, complications and recurrence rate. METHODS: This is a prospective study conducted on a 30 patients of pilonidal sinus who were admitted in Department of General surgery, Coimbatore medical college hospital for a period of 1 year from December 2017 to December 2018 after met with inclusion and exclusion criteria. They were subjected to surgical treatment, either by rhomboid excision and Limberg flap procedure (Group-A) or by excision and primary closure (Group-B). Operation time, early complications, postoperative day were recorded for both groups. Complete recovery time and late complications like delayed wound healing, hypertrophic scar and keloid after one month of surgery were recorded and long term follow up after 6 months were performed. Patients were also reviewed for recurrence and patient satisfaction with the operation and scar formation. Then the two groups were compared. Data were analysed with SPSS software and chisquare and student t tests were applied. P<0.05 was considered as statistically significant. RESULTS: In our study, there was a male preponderance in a ratio of 3:1. Mean age at presentation is noted to be in the range of 28.47 ± 8.068 years. The disease was more common in persons having occupation of prolonged duration of sitting. Clinical presentations varied from pain, discharge to swelling in the midline sacrococcygeal region. The early post op complications, pain scores on pod-1 and pod-4, day of pain free sitting and toileting were noted. All these patients were followed at one month and six months post surgery. There was a significant difference found between 2 groups in terms of pain free sitting and toileting, pain scores on pod-1 and pod-4, recurrence and patient satisfaction. CONCLUSION: Although limberg flap procedure has similar complications as excision with primary closure, it has a advantages of earlier return to physical activity, faster wound healing,lesser hospital stay, lower pain scores, less recurrence and good patient satisfaction. Therefore limberg flap procedure is best recommended for the management of uncomplicated sacro-coccygeal pilonidal sinus disease.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711311 |
| Uncontrolled Keywords: | Pilonidal Disease, Natal Cleft, Pain, Sinus, Discharge, Limberg Flap, excision with primary closure, Recurrence. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Feb 2021 18:03 |
| Last Modified: | 10 Feb 2021 18:03 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14022 |
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