Plastic procedures have some advantages, such as short duration of hospitalization, quick healing time, low risk of wound infection, and lower recurrence rates. Final view of limbergs flap 21 discussion in this study, all. Rhomboid excision and limberg flap reconstruction for pilonidal sinus is a satisfactory method of achieving surgical cure of disease. Hospital visit from the carol burnett show full sketch duration. Among them, the most commonly used is the rhomboid excision with the limberg flap. Treatment options for pilonidal sinus mdedge dermatology.
Flap techniques have been associated with lower complication and recurrence rates. Limberg flap versus karydakis flap for treating pilonidal. Traditionally, as many as four flaps can be raised from one rhomboid, if required 3. Pilonidal disease is an inflammatory disease seen in the intergluteal region. Sacrococcygeal pilonidal sinus, limberg flap, flap necrosis. A total of 93 patients were included in this study. With the limberg flap technique, internal flap cleft can be flattened and tissue can be approximated without tension. Background and aims the aim of this study is to analyze and compare the early complications and recurrent results of zplasty, limberg flap, and asymmetric modified limberg flap both demographically and clinically. Live surgery limberg rhomoid flap for closure of skin. The limberg flap reconstruction the optimal surgery for pilonidal sinus disease. Materials and methods between march 2009 and february 2010, a total of 45 patients with pilonidal sinus were enrolled in this study.
Tensionfree primary closure compared with modified limberg flap. Comparison of modified limberg flap and karydakis flap. Comparison of limberg flap and tension free primary closure during pilonidal sinus surgery. Recurrence can be observed in the excision site at the lower midline apex of the rhomboid flap following the classic limberg flap. E transposition of the rhomboid flap to fill the primary defect and securing it to the postsacral fascia. Limberg flap for sacrococcygeal pilonidal sinus a safe and. Comparison of modified limberg flap and modified elliptical rotation. Limberg flap reconstruction for sacrococcygeal pilonidal sinus. Methods the records of primary psds who underwent lfr and pc due to psd were retrospectively examined. This flap is very useful for small defects on the face or other areas. First, the area was marked as described for the original limberg flap technique fig. The rhomboid flap of limberg is a transposition flap that has been advocated for treatment of this condition.
The limberg flap is a series of communicating equilateral triangles. The current evidence is inconclusive as to which is the optimal technique. The operation produces a tensionfree flap of unscarred skin in the midline fig. In 1984, azab 3 first adopted this transpositional flap for the treatment of pilonidal sinus disease. Modified limberg flap technique in the treatment of. A modified limberg flap versus z plasty flap technique in. Limberg flap in the treatment of pilonidal disease. The limberg flap reconstruction and the karydakis flap reconstruction are the 2 most used offmidline closure techniques in pilonidal sinus surgery. However, overall early postoperative complications occurred in the limberg flap group at a rate of 24. This prospective study has been performed to determine effects of the limberg flap rotation surgery for sacrococcygeal pilonidal sinus, its feasibility to the patients, their compliance, and outcomes such as wound infection, postoperative pain relief, recurrence rates, and return to. The innovative design of the limberg flap allows for tensionfree closure of the rhomboidshaped defect and the donor site. The rhomboid limberg flap is a transposition flap that, like the bilobed flap and the zplasty, depends on the pliability of the adjacent skin, which can be determined by pinching various areas between the thumb and forefinger. The limberg flap technique has several drawbacks including undesirable cosmetic.
The patients were assigned consecutively by the closedenvelope technique to one of two groups. Comparison of excision with primary repair versus limberg flap. Comparison of surgical limberg flap technique and crystallized phenol application in the treatment of pilonidal sinus disease. In conclusion, i would propose that the rhomboid limberg flap, single or multiple, can be applied with extreme safety and should be your first choice for many. Original article sstandardization of modif ied limberg. The flaps pedicle maintains subpapillary and subdermal vascular plexuses to provide superior. A diamond rhomboid shaped piece of skin and underlying fat is removed and a plastic surgical type of procedure is used to mobilise a similarly shaped piece of skin from the. Rhomboid excision with limberg flap a novel treatment for. Pdf comparison of zplasty, limberg flap, and asymmetric. The rhomboid limberg flap can be used to close defects almost anywhere on the body. The study population consisted of 91 patients with.
Once the most appropriate flap has been chosen and raised it is,hrouh 6o and placed in the defect fig. Mehmet tokac, ersin gurkan dumlu, murat seyit aydin, abdussamed yalc. The proper technique for raising these flaps is described. The aim of the present study is to compare the modified limberg flap versus the z plasty flap technique in the treatment of. Rhomboid excision with limberg flap a novel treatment for pilonidal sinus 689 p j m h s vol. The borders of the rhomboid excision and the limbergmodified limberg flap were defined with the acetate template and drawn on the gluteal region by using a water resistant multipurpose pen. Cureus analysis of the relapse rates of the primary. In this study, 67 patients with sacrococcygeal pilonidal disease were managed with rhomboid excision and limberg flap reconstruction. Karydakis operation, vyz plasty, and limberg flap and oval flap techniques. For a long time, this option for plastic surgical coverage was used mainly in facial and plastic surgery. Limberg flap reconstruction for pilonidal sinus disease. Comparison of limberg flap and oval flap techniques.
My partner looks after our daughter at home four days a week and i am not sure if he will be fit to look after her and. Pdf rotational gluteal flap versus modified limberg flap in. Limberg flap consists of symmetrical rhomboid shaped excision in which the apices are placed on the midline. Limberg definition of limberg by the free dictionary. A rhomboidshaped excision of the sinus tract was performed en bloc and was then extended down. Limberg flap versus karydakis flap for treating pilonidal sinus disease. This flap became internationally known and was subsequently referred to as the limberg flap. The rhomboid limberg flap can be used to close defects almost any where on the body. The study included patients whose surgical intervention was performed at least two. The rhomboid flap is a flap of skin and subcutaneous tissue that is rotated around a pivot point into an adjacent defect 11. Flap techniques reduced psd recurrences and wound morbidity due to tension free healing site.
Limberg flap 129 conclusion the limberg flap demonstrated good results. Limberg flap this is a much more extensive procedure for people who either have extensive pilonidal disease or who have disease affecting both sides of the buttocks. The dufourmentel modification of the limberg flap advances in. The techniques versatility, when combined with good preoperative planning, precise marking and careful handling of the flap during the surgical procedure, allows such results to be reproduced in several areas of the face. Prospective data collection the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Patients in both groups were not allowed to resume their work until they were free of discomfort and pain during normal daily activities. Limberg flap for sacrococcygeal pilonidal sinus a safe and sound. Sacrococcygeal pilonidal sinus scpsd is an acquired condition usually seen in young adults especially males. Dufourmentel rhomboid flap for sacrococcygeal pilonidal. It is versatile in that a random pattern flap can be raised from any one or all corners of the rhomboid. In this study, our aim was to compare the efficacy of the limberg flap versus a tension free primary closure. Flap techniques reduced psd recurrences and wound morbidity due to tensionfree healing site. Pdf limberg flap reconstruction for pilonidal sinus. Background this study aimed to assess the relapse rates at the longterm followup of the limberg flap repair lfr and primary closure pc methods in the surgical treatment of pilonidal sinus disease psd.
There are many methods described for the treatment of sacrococcygeal pilonidal sinus disease, and none of them has been accepted as an optimal modality. Etiology, size, location, surgical procedures, outcomes and complications, final evaluation according to the tumor free survival and patient satisfactions in terms of aesthetic appearance were analyzed, the. A literature search turned up 54 articles on the use of the rhomboid limberg flap in all areas of the. Wplasty, limberg flap, rotation flap, gluteus maximus musculocutaneous flap, sacral adipofascial turnover flap, v y fasciocutaneous advancement flap and skin flap of the cleft lift procedure 2 3 9 11 12. Comparison of limberg flap and oval flap techniques in. The carol burnett show official recommended for you. Our dermatology online original article the limberg flap. Comparision of the limberg flap with the vy flap technique in the. Sacrococcygeal pilonidal disease is a common chronic condition usually affecting young adults under 45 years. A total of 1119% had complications including a major wound infection causing wound disruption and 3 4. This orientation creates a flap that is the same size as the defect to be excised. If a lesion can be completely excised within a fusiform segment of skin, and if the ensuing defect can be closed by straight advancement of its skin borders, then that is the procedure of. Eyedropshaped, modified limberg transposition flap in the. This is a video of a surgical demonstration of a limberg flap for the closure of a small defect on the face from skin cancer.
Pdf limberg flap reconstruction for sacrococcygeal pilonidal sinus. The limberg flap procedure is a safe choice for the surgical treatment of sacrococcygeal recurrent pilonidal sinus disease due to its low complication rate, short length of hospital stay, early return work, low vas score, high patient satisfaction and shorter complete healing duration. No major anesthetic complication or wound infection developed. All of these patients were free of infection at the time of the operation. Conclusion limberg flap is very effective for pilonidal disease with low complication rates, short hospitalisation, low recurrence rates, earlier healing and shorter time offwork.
Rhomboid excision with limberg transposition flap in the. The aim of this study is to assess the effectiveness of the modified limberg flap technique with eyedrop excision in the treatment of pilonidal sinus disease. The efficacy of limberg flap reconstruction for pilonidal. Pdf on oct 15, 2017, dr atul sharma and others published limberg flap repair. Pdf on jan 17, 2018, hesham elgendy and others published rotational gluteal flap versus modified. The disease usually occurs in the intergluteal region, although it may occur elsewhere such as at the umbilicus and in the finger webbing in hair dressers. Pilonidal sinus disease is an inflammatory disease seen in the intergluteal region, which is a commonly encountered problem in surgical practice that mostly affects young people. Therefore, the classic limberg flap was modified in 2004 to prevent this complication. Limberg flap repair for pilonidal sinus disease springerlink. Limberg synonyms, limberg pronunciation, limberg translation, english dictionary definition of limberg. With this technique of flattening the natal cleft, a tensionfree repair is. Effectiveness of limberg and karydakis flap in recurrent.
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