Modified Limberg flap technique can be standardized by using an acetate template for the management of pilonidal disease
Limberg flap template
DUPLICATION FROM: Yuksel ME. Standardization of modified Limberg flap technique by using an acetate template for the treatment of pilonidal disease. Our Dermatol Online. 2019;10(2):112-115. DOI:10.7241/ourd.20192.1
The modified Limberg flap is a commonly used surgical procedure for the treatment of pilonidal disease. However, studies which compared the outcomes of modified Limberg flap technique reported conflicting results. Different shape and size of the raised flaps and varied lateralization distances lead to differences in healing time, complication and recurrence rates. However, standardization of the modified Limberg flap technique can help to compare the end results of this surgical intervention more accurately. Thus, we have developed an acetate template to draw a sketch map of rhomboid excision and modified Limberg flap preoperatively, in order to standardize the modified Limberg flap procedure.
A modified Limberg flap template was prepared using an online drawing program. Rhomboid flaps with four different sizes were drawn. The template was printed onto an acetate sheet. With the help of a sewing needle, pin holes were performed on the acetate template. The borders of the rhomboid excision and the modified Limberg flap were drawn onto the gluteal region by using a water resistant pen. The surgeon decided which rhomboid flap size to choose according to the dispersion of the pilonidal pits. All pilonidal pits stayed within the resected area. Thus, the size of the modified Limberg flap was standardized.
This study included ten male patients with pilonidal disease between the ages of 20 to 35. All of the patients underwent modified Limberg flap surgery using the standardized acetate template. The follow-up period was six months. Only one patient had surgical site infection on the postoperative day 7.
We recommend that using a standardized template during modified Limberg flap operation for the management of pilonidal disease may help to evaluate and compare the end results of this surgical intervention more accurately.