TPW 7.07 Excision with Primary Closure vs Limberg Flap for Pilonidal Sinus Disease: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

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ID: 323988
2026
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Abstract
Abstract Background Pilonidal sinus disease is a common condition that often requires surgical interventions. Among the available surgical techniques, Limberg flap reconstruction (LF), excision, and primary closure (PC) are the two most commonly used approaches. This study aimed to compare perioperative outcomes, including operative time, length of hospital stay, pain scores, wound infection, wound dehiscence, and recurrence. Methods The research process was meticulous and thorough, ensuring the reliability of our findings. We identified eight randomised controlled trials (RCTs) that compared LF and PC from electronic databases. We performed a meta-analysis using Review Manager (RevMan, version 5.4. The Cochrane Collaboration), to assess operative time, pain scores on day one, hospital stay, infection, and recurrence. Results We included 974 patients in the eight RCTs. The mean operative time was significantly longer in the LF group than in the PC group. The mean duration of hospital stay was slightly longer in the patients with PC. LF had lower postoperative infection rates than PC. Recurrence rates were significantly lower in the LF group. The wound dehiscence rates were lower in the LF group than in the PC group. Postoperative pain scores on the visual analogue scale (VAS) were lower with LF than with PC. Conclusion Despite a longer operative time, LF is superior to PC for pilonidal sinuses, offering a shorter hospital stay, less pain, lower infection and wound dehiscence rates, and reduced recurrence. This underscores the importance of continued research and innovation in pilonidal sinus treatment.
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Authors Nida Khan, Shantanu Chandrashekhar, Premjithlal Bhaskaran, Christi Swaminathan
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.377
URL
https://doi.org/10.1093/bjs/znag087.377
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