In Patients with Recurrent Pilonidal Sinus, Should the First Approach be Crystallised Phenol or Limberg Flap?

Abstract

Aim:In our study, we aimed to compare the efficacy of Limberg flap and crystallised phenol treatments applied to patients with recurrent pilonidal sinus.Method:Patients with recurrent pilonidal sinus disease who were treated with the surgical excision Limberg flap technique and crystallised phenol method in our hospital General Surgery Clinic between 2017 and 2019 were evaluated retrospectively. The patients were assessed according to age, gender, hospital stay, smoking, infection, return-to-work period and recurrence rates.Results:A total of 25 patients who underwent Limberg flap treatment due to recurrent disease and 32 patients who were treated with the phenol method were identified retrospectively. Patients with missing data were excluded, and 40 patients were included in the study. In all, 72.5% of the patients were male. The mean age of the Limberg group was 25.25±6.12, and that of the crystallised phenol group was 24.60±6.11. While the mean hospital stay was 2.05±0.75 days in the Limberg group, all patients were discharged on the same day in the crystallised phenol group (p<0.001). The return-to-work period in the Limberg group was significantly higher (p<0.001). The cosmetic appearance was significantly better in the crystallised phenol group (p=0.02).Conclusion:The less invasive method of phenol treatment may be preferred as the first treatment method in recurrent patients since it is more advantageous than the post-excision flap procedures in terms of the length of hospital stay and cosmetics.

Keywords

• recurrent pilonidal sinus
• crystallised phenol
• limberg flap