Analysis of the Relapse Rates of the Primary Closure and Limberg Flap Techniques in Pilonidal Sinus Surgery

Background This study aimed to assess the relapse rates at the long-term follow-up of the Limberg flap repair (LFR) and primary closure (PC) methods in the surgical treatment of pilonidal sinus disease (PSD). Methods The records of primary PSDs who underwent LFR and PC due to PSD were retrospectively examined. The study included patients whose surgical intervention was performed at least two years ago. The patients were contacted by phone to obtain information. They were asked whether they had a relapse or not, and their answers were recorded. The recording and analysis were ensured using the SPSS statistical program (IBM Corp, Armonk, NY, US). The groups were compared using the chi-square test. p˂0.05 was considered significant. Results The patients’ mean age was 23.68 ± 8.21 years, and their median age was 22 years. The overall follow-up period was 4.38 ± 2.12 years. LFR-treated patients numbered 292; 38 (13.01%) females and 254 (86.99%) males. Of the LFR-treated patients, 23 (7.87%) had a relapse, including five (13.15%) females and 18 (7.08%) males (p˂0.03). PC-treated patients numbered 184; 58 (31.52%) females and 126 (68.48%) males. Of PC-treated patients, 39 (21.19%) had a relapse, including 15 (25.86%) females and 24 (19.04%) males (p˂0.04). The relapse was more than three times higher in PC when compared to LFR (p˂0.01). Conclusion LFR clearly takes precedence over PC. In both methods, the relapse rate is higher in females. We believe that this is due to our tendency to be more limited in resection in women.