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Dr. Gaurav Bansal

MBBS, MS - General Surgery, FIAGES - Minimal Access Surgery, Fellowship in Advanced Minimally Invasive and Robotic Surgery.

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Pilonidal Sinus: Recent limberg Flap Technique

Pilonidal disease is a type of skin infection which typically occurs between the cheeks of the buttocks and often at the upper end.

Pilonidal sinus (PNS): is a sinus tract or small channel, may originate from the source of infection and open to the surface of the skin. Material from the cyst may drain through the pilonidal sinus. A pilonidal cyst is usually painful, but with draining, the patient might not feel pain. Diagnosis is based on symptoms and examination.

Signs and symptoms

Causes

Treatment

Antibiotic therapy

If there is an infection, treatment is generally by incision and drainage just off the midline. Shaving the area may prevent recurrence.

More extensive surgery may be required if the disease recurs.

Excision of Cyst (along with pilonidal sinus tracts). Post-surgical wound packing may be necessary, and packing typically must be replaced once daily for 4 to 8 weeks. In some cases, two years may be required for complete granulation to occur.

Limber Flap Technique

Reconstructive flap technique, such as a "cleft lift" procedure or Z-plasty, usually done under general anaesthetic. This approach is especially useful for complicated or recurring pilonidal disease, leaves little scar tissue and flattens the region between the buttocks, reducing the risk of recurrence. This approach typically results in a more rapid recovery than the traditional surgery, does not require dressings or packing and allows the return to normal activities within 1 to 2 days.

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