Comparison of modified limberg flap and modified elliptical rotation flap for pilonidal sinus surgery: A retrospective cohort study

• Elliptical rotation flap was used by nessar et al. and the weak points of the technique were described.
• Modified elliptical rotation flap technique and its advantages and superiority over elliptical rotation flap was described.
• The study showed that modified elliptical rotation flap technique is a feasible and effective procedure for pilonidal sinus disease.

BackgroundAlthough various surgical procedures have been described for pilonidal sinus disease, the best surgical technique is still controversial. Aim of this study was to compare the short term results of modified limberg flap (MLF) and modified elliptical rotation flap (MERF) for pilonidal sinus disease in terms of postoperative complications, recurrence and patient satisfaction.Materials and methodTwo hundred and thirty six patients (43 female, 193 male) who were operated on for sacrococcygeal pilonidal sinus disease between January 2010 to December 2013 were retrospectively analyzed. 115 patients underwent Modified limberg flap (MLF) procedure and 121 patients underwent modified elliptical rotation flap (MERF) procedure. The median follow-up period was 22 months (range, 4–34). Complication and recurrence rate were the mean end points of the study.ResultsSurgical area related complications were lower in MERF group than in MLF group, but the difference was not statistically significant. Patients in the modified elliptical rotation flap group had shorter operation time, better cosmetic results and earlier return to normal social life than modified limberg flap group. There were no recurrences in MERF group but one recurrence in MLF group.ConclusionModified limberg flap reconstruction is still one of the most commonly performed procedures for pilonidal sinus disease because of its low complication and recurrence rate and higher postoperative quality of life. This study shows that modified elliptical rotation flap technique is at least effective as modified limberg flap reconstruction. Further prospective clinical trials are needed to show the effectiveness of this technique on long term.