Primary Closure vs Limberg Flap for Pilonidal Sinus-Meta-Analysis and Systematic Review

J. A. Jayalal, Selwyn J Kumar, J. Ajin Manovah, Ajin Daniel, J. Soundhariyakamakshi

Abstract: Background: Pilonidal sinus is characterized by chronic inflammation and recurrent infections in the sacrococcygeal region. Pilonidal sinus primarily affects young males and has an incidence rate of 26 per 100,000 people, according to reports. Obesity, poor personal hygiene, and unhealthy habits like prolonged sitting are its risk factors. It has a significant risk of recurrence and a lot of consequences like persistent non healing wounds, infection and possibly sinus tract squamous cell carcinoma [1]. Methods: Systemic review and meta-analysis were performed according to PRISMA guidelines. Forest plots were generated and treatment effects calculated from each study. Results: Limberg Flap is associated with lesser infection than primary closure with the pooled risk ratio of 0.3. Limberg Flap is reported as the lesser occurrence for wound dehiscence than primary closure with the pooled risk ratio of 0.1. Limberg Flap is associated with fewer days of hospital stay in all of the seven studies with pooled MD of 7 days. Return to normal activities was significantly shorter for Limberg Flap compared with primary closure with the pooled MD of 21 days. Conclusion: The study concluded Limberg Flap is better than primary closure.

Keywords: pilonidal sinus, young males, Limberg Flap, risk factors, treatment outcomes