Use of the limberg flap to close breast wounds after partial mastectomy. All sinus tracts were resected en bloc, and the fasciocutaneous limberg flap was prepared from the gluteal region and closed it with a suction drain. Flap techniques have been associated with lower complication and recurrence rates. Sacrococcygeal pilonidal disease pd is commonly treated with excision and primary closure techniques epc. 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. A total of 252 patients were included in the study. This flap was easy to perform, with sutures away from the midline giving rise to a tensionless flap of unscarred skin in the midline, which helps in good hygiene maintenance, reducing sweating maceration, erosions, and scar formation. Comparison of excision with primary repair versus limberg flap. To prepare the flap must determine the number of layers must be replaced, and the area of skin that will cover the defect. Limberg flap in the treatment of pilonidal disease. This flap was easy to perform, with sutures away from the midline giving rise to a tensionless flap of unscarred skin in the midline, which helps in good. Pilonidal sinus is a disease of young adults having single or multiple blind tracks lined by granulation tissue containing tuft of shed hair. Since then, the flap have been modified by other authors, increasing its versatility, notedly the triple flap technique, which is.
A modified limberg flap versus z plasty flap technique in. I was in a similar position to you, id had 4 surgeries 1 open, 1 closure, 1 bascomes cleft lift, 1 karydakis, all of which failed to heal fully and have been the bane of my life for the past 2. The aim of this study was to compare excision with primary repair versus the limberg flap. These cases show that preoperative design and attention to placement in relation to skin extensibility is important. The dufourmentel modification of the limberg flap advances in. Sykes, mdb from the adepartment of otolaryngologyhead and neck surgery, medical university of south carolina, charleston, south carolina. With the limberg flap technique, internal flap cleft can be flattened and tissue can be approximated without tension. One of the more useful regional flaps is the thenar flap, detailed in this classic article pdf file. Four hundred and sixteen patients with psd were operated on under spinal or general. The numbers of techniques are testament in treating pilonidal sinus pns and no single procedure is superior in all aspects. In addition, this flap is used in hand reconstruction and breast reconstruction. Rhomboid flaps dont reflect the shape of the flap but literally the shape of the defect. Prospective data collection the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. Pilonidal sinus disease has been treated for a long time with conventional open excision technique. Trends in surgical treatment of pilonidal sinus diseases. Surgical technique a simple modification with the limberg flap for. The defect is filled with tissue of the same thickness and colour, and with good vascularity. 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. This operation has been used in 7 cases to reconstruct breasts after partial mastectomy and axillary clearance of glands and has given a good cosmetic result. However, post surgical counseling for hair removal is very important in order to prevent recurrence. The thenar flap provides an excellent tissue match of color, texture, bulk and contour of the lost finger pulp. This study was carried out to evaluate the advantages and results of rhomboid excision. Anatomic effect of limberg flap for pilonidal sinus disease.
We present a case of a 60yearold man exfarmer now in retirement with diabetes mellitus type 2 and essential. Eritema malar pdf the first criterion is a malar rashref77 characterized by an erythema over the cheeks and nasal bridge but sparing the nasolabial folds, which is in. We analyzed midterm results from our center after introduction of mit to treat pd. The rhomboid flap of limberg is a transposition flap that has been pleaded for treatment of this. Limberg definition of limberg by the free dictionary. Pilonidal sinus defect closure, reconstruction methods 1. Full primary healing was obtained in 110 patients, 1 patient had minimal necrosis of flap and 2 had gaping of flap.
Accelerated healing of complex open pilonidal wounds using. Limberg synonyms, limberg pronunciation, limberg translation, english dictionary definition of limberg. In some cases, the donor site cannot be closed primarily and may require a skin graft. The rhomboid flap of limberg is a transposition flap that has been advocated for treatment of this condition.
Limberg flap for sacrococcygeal pilonidal sinus a safe and. Home september 1976 volume 58 issue 3 limberg flap coverage for axillary defects resulting from ex. Rhomboid excision with limberg flap a novel treatment for sacrococcygeal pilonidal sinus faisal shabir, bahzad akram khan, muhammad azeem mian abstract background. It is versatile in that a random pattern flap can be raised from any one or all corners of the rhomboid. Listing a study does not mean it has been evaluated by the u. 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 choice. Although many techniques have been used to treat pilonidal sinus disease in adults, few studies have compared treatment methods for the condition in teenagers. A total of 1119% had complications including a major wound infection causing wound disruption and 3 4. Hidradenitis suppurativa is a challenging aspect and requires a proper treatment plan which may involve different specialties. Outcome of the limbergs flap technique in the treatment of pilonidal sinus naveed akhtar,1 shafiq ullah,2 muhammad sabir2 abstract background. The proper technique for raising these flaps is described. It can be associated with fistulating sinus, scarring and abscesses formation. Bilateraltranspositionlipflaps anovelsinglestagereconstructionofcentral upperlipdefectsinvolvingcupidsbow andrewa. Pilonidal sinus defect closure, reconstruction methods.
Use of the limberg flap to close breast wounds after. They were treated by phenol injection, excision and. Full thickness local flaps with random pattern blood supply relying on dermalsubdermal plexus of vessel a rhomboid flap pivots and also advances towards the defect requiring extensive undermining of the of the skin at the base of the flap. However, these cases also demonstrate that placement of incision lines in. Below is a list of common and eponymous plastic surgery flaps with their classification and common usage. After seeing how much pain they have caused some of you all, i realize that was a blessing. Pilonidal sinus disease is a common medical condition that accounts for almost 15% of anal suppurations with high morbidity. Full text full text is available as a scanned copy of the original print version. Limberg procedure is a safe and reliable technique in the treatment of sacrococcygeal pilonidal sinus disease, with low. 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. Frontiers minimally invasive surgical treatment of.
Pilonidal sinus is a relatively common condition affecting men twice as often as women. However, depending on the location of the defect, rotation flaps may be preferable to transposition or advancement flaps. Once the most appropriate flap has been chosen and raised it is,hrouh 6o and placed in the defect fig. Nb the terms interpolation flap and pedicle flap can be used interchangeably. The aim of this study was to compare two operative procedures modified limberg flap versus z plasty flap in management of recurrent. Pilonidal sinus disease psd is usually seen on the sacrococcygeal region in adolescent patients. Pilonidal disease is an inflammatory and infectious soft tissue disorder of the sacrococcygeal intergluteal region. Anatomic effect of classical limberg plastic surgery procedure in the. Relative contraindications include large transverse or oblique abdominal incisions. Pilonidal sinus disease is a common condition, which mostly affects young men. Effectiveness of limberg and karydakis flap in recurrent. Various surgical and nonsurgical modalities are used for managing this condition. The rhomboid limberg flap can be used to close defects almost anywhere on the body.
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. In this study, we aimed to compare the modified limberg flap technique with the excision and primary closure technique, both of which are used routinely in adults and teenage patients. Comparison of the classic limberg flap and modified. Pdf comparison of the classic limberg flap and modified. Case series on modified limberg flap technique in management of pilonidal disease akheel ahmed1 and srikar billa1 research paper pilonidal abscess and sinus in sacrococcygeal area are a common occurrence in youth. Alternatively, you can download the file locally and open with any standalone pdf reader. There are controversies about the etiology and management of recurrent pilonidal sinus. Pdf limberg flap reconstruction for pilonidal sinus. O b j e c t i v e s statement of the problem general evaluation if the condition.
Comparison of limberg flap and oval flap techniques in sacrococcygeal pilonidal sinus disease surgery. The management of pilonidal sinus disease remains controversial, and gold standard treatment modality has yet to be established. Modified limberg flap technique in the treatment of. Minimally invasive techniques mit, such as epsit and pitpicking, had been recently advocated promising better outcomes. A literature search turned up 54 articles on the use of the rhomboid limberg flap in all areas of the. Hey, all a few months ago, i discovered my cyst, and began the journey to get it removed. The rhomboid flap, described by limberg in 1946, is widely used in reconstructive procedures aind is considered to be a safe and effective flap option. In this study, our aim was to compare the efficacy of the limberg flap versus a tensionfree primary closure. Live surgery limberg rhomoid flap for closure of skin. A total of 93 patients were included in this study.
The present paper demonstrates the versatility of the rhomboid flap. Comparison of the classic limberg flap and modified limberg flap in the treatment of pilonidal sinus disease. The current study analyzed the outcome of the rhomboid excision and the limberg flap procedure clf in comparison to the modified limberg flap procedure mlf for psd. We present our experience using the limberg flap technique for treating sacral pressure. Fingertip amputations remain a common problem with many treatment options ranging from simple to complex. Read modified limberg flap reconstruction compares favourably with primary repair for pilonidal sinus surgery, anz journal of surgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available. Full text get a printable copy pdf file of the complete article 610k, or click on a page image below to browse page by page. The patients were assigned consecutively by the closedenvelope technique to one of two groups. Modified limberg flap is better option for pilonidal sinus with least recurrence. Limberg rhomboid flap for sacrococcygeal pilonidal sinus was designed by limberg in 1946, who described a technique for closing a 60 rhombusshaped defect with a transposition flap. Since the original description by limberg, several modifications of the flap have been described, the most important of which was by dufourmental.
Casereportcaseseries bilateraltranspositionlipflaps. The aim of the present study is to compare the modified limberg flap versus the z plasty flap technique in the treatment of. Pilonidal disease is an inflammatory disease seen in the intergluteal region. Rhomboid excision with limberg flap a novel treatment for. Mine didnt hurt much, just drained a lot and put pressure on my skin. Wide, complete excision of the abnormal tissue remains the dominant treatment, although controversy exists with respect to the preferred extent of excision, techniques and preferences for attempted primary closure, and. Hidradenitis suppurativa hs is a chronic inflammatory cutaneous disorder that involves the infundibular terminal follicles in areas rich of apocrine glands. Hey jenquack, i had a limberg flap done only 2 weeks ago. One group underwent excision with primary repair and the other group rhomboid excision with the limberg flap. The rhomboid flap has become a popular reconstructive alternative for facial defects in recent years.