Is Adipopfascial Flap Superior to Limberg Flap in Surgical Treatment of Pilonidal Sinus? A Prospective Randomized Clinical Study

Background: Pilonidal sinus disease (PSD) encompasses inflammation localized to the intergluteal cleft, ranging from minor cyst to extensive sinus formation. The most important parameters in the treatment of the disease are early return to work, low recurrence rate, low postoperative pain, high comfort, low complication rate, and low cost. In the surgical treatment of pilonidal sinus disea-se, there are methods such as flap methods, primary closure, and unroofing and curettage. Materials and Methods: This study was planned as a prospective randomized clinical trial with pati-ents who were operated with the diagnosis of chronic pilonidal sinus. A total of 104 chronic piloni-dal sinus patients were randomized into two groups. The first group underwent Limberg flap proce-dure for treatment. The second group underwent adipofascial flap procedure for treatment. The two groups were compared in terms of demographic characteristics, duration of surgery, early and late complications, recurrence, and follow-up time. Results: The operation time was shorter in Group 2 than in Group 1. The difference was statistically significant. Wound dehiscence was significantly less common in Group 2. The aesthetic satisfaction was significantly higher in Group 2. Recurrence rates were not different between the Limberg and adipofascial groups (49/4 and 55/4, 8% and 7%, respectively). Conclusions: Our study showed that the adipofascial flap can be easily applied in the surgical treat-ment of pilonidal sinus disease and has no difference from other flap methods. To minimize regret for surgical decisions, people with PSD need better information on the burden of wound care and the risks of recurrence associated with different surgical approaches.