Tension-free primary closure compared with modifi ed Limberg flap for pilonidal sinus disease: a prospective balanced in randomized study

Background: Pilonidal sinus disease (PSD) is a common disease that affects the patient’s quality of life. We analyzed the outcome of the tension-free primary closure (TF 1ry) in comparison with the modified Limberg fl ap (MLF) technique. Patients and methods: A total of 120 patients suffering PSD were assigned to one of two equal groups by closed envelope balanced randomization. Group I represents TF 1ry method and group II represents MLF. Results: There were 102 (85%) male patients and 18 (15%) female patients elected for surgery. The mean follow-up period was 43.5 ± 3.4 months. There were no statistically significant differences between the two groups regarding patients’ demographic data, clinical presentation, immediate postoperative complications, and disease recurrences. The operative time, blood loss, hospital stay, surgeon’s performance scale, wound hypothesia, wound cosmoses score, patient satisfaction score, and patient quality of life (bodily pain and social functioning) were better in the TF 1ry group. The MLF group had better clinical results regarding frequency of seroma formation and time to drain removal. Conclusion: Flap techniques are effective and efficient for PSD. TF 1ry closure can be tailored for female PSD patients and a junior surgeon. MLF can be tailored for male PSD patients and a senior surgeon.