Open Method Versus Flap Closure in Pilonidal Sinus in a Rural Tertiary Care Hospital, Karnataka- A Cohort Study

Abstract

Introduction: Open excision is one of the simple surgical techniques for the correction of pilonidal sinus, in the recent times, the rhomboid excision with limberg flap is being practiced commonly due to increased patient’s satisfaction, reduced pain, etc. Aim: To assess the surgical outcome of open excision and rhomboid excision with limberg flap for the correction of pilonidal sinus. Materials and Methods: A hospital-based cohort study was done among patients with pilonidal sinus requiring surgical treatment, in Department of Surgery in Adichunchangiri Institute of Medical Sciences and Research Centre, B.G. Nagar, Bellur, Mandya District, Karnataka, India. The study was conducted during June 2018 to December 2019. Participants who underwent open excision were included in group A (n=40) and rhomboid excision with Limberg’s flap were included in group B (n=40). Patients were followed-up for a period of one month. The key outcome assessed were mean duration of surgery, pain during the first three postoperative days, time taken for discharge and return to work, complications and patients satisfaction. Analysis was done using Statistical Package for Social Science (SPSS) version 20.0. Results: Rhomboid excision with Limberg’s flap was found to be significantly better than open excision method in terms of pain, duration of hospital stay, time taken to return to profession, patient’s satisfaction and overall complications but there were no significant difference noted with respect to individual complication and duration of time taken for surgical procedure. Conclusion: Rhomboid excision with Limberg’s flap is comparatively better than open excision.

Keywords

• limberg’s flap
• open excision
• rural population