Comparison of Z-Plasty and Limberg Flap Techniques in Management of Sacrococcygeal Pilonidal Sinus

Introduction: Pilonidal sinus is a fairly common problem encountered in general surgical practice. Though there are many surgical techniques for its management, controversy still continues regarding best surgical technique to treat with respect to postoperative complications, patient compliance, and minimizing recurrence. Aims and Objectives: The aim of this study was to compare the two techniques of Limberg flap method and Z-plasty in the management of pilonidal sinus in terms of duration of surgery, postoperative pain, duration of hospital stay, drain removal time, postoperative complications, and recurrence rate. Materials and Methods: A prospective comparative study was conducted in the Department of General Surgery, Victoria Hospital. A total of 50 cases were included, of which 31 underwent Limberg flap procedure and 19 underwent Z-plasty. Results: The mean age of sacrococcygeal pilonidal sinus presentation was 29 years with male preponderance presenting with pain and seropurulent discharge as most common complaints. The parameters regarding the duration of surgery, the mean duration of hospital stay, postoperative complications were comparable between 2 groups. Postoperative pain was significantly less in Limberg method. The drain could be removed earlier in the Limberg flap procedure than in the Z-plasty technique, the difference being statistically significant. Conclusion: In this study, Limberg flap methods had a shorter duration of operation, lesser postoperative pain, and earlier drain removal time when compared to Z-plasty. Hence, Limberg flap may be a better alternative to Z-plasty in the management of sacrococcygeal pilonidal sinus.