Outcomes of Limberg Flap Reconstruction for Recurrent Pilonidal Sinus Disease
Overview
This single-center U.S. study evaluated long-term outcomes of Limberg flap reconstruction in 37 patients with recurrent pilonidal sinus disease. The procedure demonstrated durable disease control with no recurrences over a median 4.5-year follow-up and an acceptable 11% postoperative complication rate.
Background
Pilonidal sinus disease (PSD) is a chronic condition often requiring surgical intervention, with recurrence posing a significant challenge. The Limberg flap (LF) reconstruction technique has shown favorable results internationally but lacks extensive long-term data from U.S. centers, especially for recurrent cases. This study aimed to assess the efficacy and safety of LF reconstruction in a U.S. cohort with recurrent PSD. Understanding outcomes in this population is critical to guide surgical management strategies.
Data Highlights
Characteristic
Value
Number of patients
37
Male patients
76%
Median BMI
29.4 kg/m²
Active smokers
59%
Multiple previous pilonidal operations
52%
Median operative time
72 minutes
Same-day discharge
92%
Postoperative complication rate
11%
Median follow-up duration
4.5 years
Recurrence rate
0%
Key Findings
Limberg flap reconstruction was performed on 37 patients with recurrent PSD, predominantly male with a median BMI of 29.4 kg/m².
More than half of the cohort were active smokers and had multiple prior pilonidal surgeries, indicating a complex patient population.
The median operative time was 72 minutes, with 92% of patients discharged on the same day without surgical drains.
Postoperative complications occurred in 11% of patients, mainly wound dehiscence, reflecting acceptable morbidity.
No disease recurrence was observed during a median follow-up period of 4.5 years, demonstrating durable long-term disease control.
Clinical Implications
Limberg flap reconstruction offers a reliable surgical option for patients with recurrent pilonidal sinus disease, even in those with multiple prior surgeries and risk factors such as smoking. The procedure supports early discharge and has a low complication rate, making it suitable for outpatient management. Surgeons should consider LF reconstruction as a durable and effective approach in complex recurrent PSD cases.
Conclusion
This study supports Limberg flap reconstruction as a safe and effective technique for managing recurrent pilonidal sinus disease, achieving excellent long-term outcomes with minimal morbidity in a U.S. patient cohort.
