RECURRENCE RATES AFTER MODIFIED LIMBERG FLAP PROCEDURE FOR THE TREATMENT OF PILONIDAL DISEASE VARY BETWEEN 0%-10%: WHY IS THERE SUCH A BIG DIFFERENCE WITHIN RECURRENCE RATES?
Mehmet Eren Yüksel, Ankara Yıldırım Beyazıt University School of Medicine, Intensive Care Unit, Ankara, Turkey
Introduction: Modified Limberg flap technique is applied for the treatment of pilonidal disease.
Aim: We aimed to determine recurrence rates after modified Limberg flap procedure.
Method: A Pubmed search between 2009-2021 was performed in order to identify studies reporting complications and recurrence rates after modified Limberg flap procedure for the treatment of pilonidal disease. Nineteen studies were identified.
Results: Recurrence rates after modified Limberg flap procedure were 5.4% (Can et al., 2010), 0.97% (Akin et al., 2010), 10% (Aren et al., 2010), 1.67% (Elshazly et al., 2011), 4.2% (Kaya et al., 2012), 0% (Karaca et al., 2012), 2.8% (Ahmed et al., 2013), 3% (Bessa et al., 2013), 3.3% (Shabbir et al., 2014), 0% (Yildiz et al., 2014), 6.8% (Bayhan et al., 2015), 6.5% (Tokac et al., 2015), 0.8% (Yoldas et al., 2015), 2% (Saydam et al., 2015), 4.5% (Sabuncuoglu et al., 2015), 2% (Sarhan et al., 2016), 3.7% (Kose et al., 2017), 3.3% (Sabry et al., 2018) and 7.4% (Abdelnaby et al., 2018), respectively (Table 1).
Discussion and Conclusion: Recurrence rates after modified Limberg flap procedure for the treatment of pilonidal disease vary between 0%-10%. Dispersion of the pits in the gluteal sulcus, various flap sizes, hairiness of the gluteal region, prior wound infection within the operation field, different lateralization distances of the flaps from the midline, post-operative wound care, immunosuppression, underreporting and a short follow-up period may play role in the outcomes after surgical treatment. A drawing template which was recommended by Yuksel et al. in 2019 may help to standardize modified Limberg flap procedure in order to facilitate the comparison of end results accurately.
Keywords: Flap, Limberg, Modified, Pilonidal, Recurrence