A comparative study between Limberg flap and cleft lift procedures in the treatment of sacrococcygeal pilonidal sinus disease

Introduction
This was a prospective, randomized study designed to compare the effects and outcomes of Limberg flap (rhomboid excision) and cleft lift procedure.
Patients and methods
Between June 2014 and June 2017, 40 patients underwent surgical treatment for uncomplicated sacrococcygeal pilonidal sinus in the Surgery Department, Al-Azhar University Hospital, New Damietta. The patients were randomly subdivided into two groups: group A comprising 20 patients who underwent the Limberg flap procedure (rhomboid excision) and group B comprising 20 patients who underwent the cleft lift procedure.
Results
As regards operative time and weight of resected tissue, there was a significant decrease in group B (carried out by cleft lift procedure) in comparison with group A (carried out by Limberg flap procedure) (33±4.2, 12.1±5.23 vs. 42±5.1, 25.4±3.59, respectively). Moreover, there was a decrease in the postoperative pain (measured by a visual analog scale) in group B in comparison with group A, mainly on the first and seventh days, but this difference in the postoperative pain was nonsignificant. In addition, there was a nonsignificant decrease in the mean hospital stay and healing time in group B in comparison with group A. As regards the postoperative complications, there was nonsignificant decrease in postoperative seroma and superficial skin separation in group B in comparison with group A. The recurrence rate shows no statistically significant difference between the two groups.
Conclusion
Both the cleft lift and the Limberg flap procedures gave similar good results, except that the cleft lift procedure has a shorter operative time.