RESUMO
Different procedures have been advocated for the management of chronic pilonidal sinus [PNS], none of which is perfect. This study was conducted to compare between the Limberg flap technique and conventional midline closure in patients with chronic PNS. The onset of PNS is rare both before puberty and after the age of40.Males are affected more frequently than females, probably due to their more hirsute nature [Sondenaa etal [1995]]. In a population study of 50,000 students, the incidence in males was 1.1%, ten times more than in females [Dwight and Maloy [1953]], although many of these were asymptomatic. This study included 20 patients with chronic pilonidal sinus admitted to the department of surgery between Feb 2005 and June 2006. Good history as regarding, duration, number of sinuses and their location, previous management operative technique and time, hospital stay, return to normal activity, morbidity, and recurrence of disease. Patients were categorized into 2 groups. Patients in-group 1 [n = 10] were treated with the rhomboid flap, whereas those in-group 2 [n = 10] were treated with the standard midline closure technique, with a follow up period ranging from 12m-18 months. Twenty patients underwent with this technique, mean age 23.4 years [range 18 to 34]. Mean follow-up was 13 months. The mean time of patients discharge was 3 days [range, 2-5 days] postoperative. Complication was noticed more with midline closure [3 of 10 [30%]] as compared with rhomboid flap technique [1 of 10[10%]]. Recurrence was observed in 2 cases [20%] with midline closure while no recurrence was observed with patients treated with rhomboid flap technique. Rhomboid flap is recommended for patients with chronic PNS as it is a simple, nonlengthy procedure that has less overall complications and a lower recurrence rate than the conventional midline closure method. Chronic pilonidal sinus [PNS] is a common disabling disorder among young adults. It has a high and rising incidence in some countries, particularly so in the Mediterranean and Gulf region as a result of differing hair characteristics and growth patterns [Aldean etal [2005]], [Sakr etal [2006]]. The treatment of the symptomatic pilonidal sinus is surgical with one of the most extensive being excision of the diseased tissue down to the sacral fascia. The closure of the defect is the matter of debate. An operation that results in reliable primary wound healing and few complicate and recurrence, a short period of hospitalization, minimal postoperative pain and morbidity, rapid return to normal daily activity, and low risk of recurrence are seen as requirements to optimal therapy [Berry [1992]], [Karydakis [1992]]. This study compare the result of rhomboid flap technique and the midline closure for the management of chronic pilonidal sinus as regard duration of wound healing, home stay, complication and recurrence of the disease [Katsoulis etal. [2006]]