Original Article

Comparison of Limberg Flap and Modified Limberg Flap in the Surgical Treatment of Pilonidal Sinus

  • Acar AREN
  • Alper Dursun ŞAĞBAN
  • Aylin Hande GÖKÇE

IMJ 2010;11(4):149-153


Pilonidal cysts are most frequently located in the sacrococcygeal region. In this prospective study, we aimed to present the results of follow-up studies of two groups of pilonidal cyst cases who had different surgical treatments.


This prospective and randomized study was planned for patients who applied to surgical clinics between 2007-2009 and were diagnosed as chronic pilonidal sinus disease. All cases were divided randomly into two groups. In the first group, patients underwent rhomboid sinus excision and Limberg flap method (Group A, n=50). In the second group, patients underwent rhomboid sinus excision and modified Limberg flap with no midline incision (Group B, n=50). The results were compared.


The study group consisted of 13 female and 87 male patients in total. When the two groups were compared, there was no significant difference between complaint and relapse rates. However, in Group A, surgical wound dehiscence rates were two-fold more than in Group B. In this study, we found that rhomboid sinus excision and modified Limberg flap method in the treatment of pilonidal sinus was as safe and efficient as the Limberg flap method. Although not statistically significant, we also observed less surgical wound dehiscence when using the modified Limberg flap method.


Consequently, in managing pilonidal sinus disease, the modified Limberg flap method can be considered a reliable modality, but more randomized controlled studies are needed.

Keywords: Modified Limberg flap, pilonidal sinus, rhomboid sinus excision