Plastic and Reconstructive Surgery Unit, Minia University, Minia City, Egypt.
J Plast Reconstr Aesthet Surg. 2010 Jul;63(7):1176-80. doi: 10.1016/j.bjps.2009.05.051. Epub 2009 Jul 18.
Many procedures have been proposed for the management of sacrococcygeal pilonidal sinus disease. The aim of this work is to evaluate the superiorly based flap (used before for reconstruction of pressure sore) for reconstruction after excision of sacrococcygeal pilonidal sinus.
Between January 2004 and February 2007, 25 male patients of ages between 14 and 29 years(median age: 23 years), who had recurrent pilonidal sinus, underwent surgical treatment by the Limberg flap technique. The mean duration of symptoms was 5.2 + or - 4.5 years (range 3-6 years). Rhombic-shaped excision of the sinus-bearing skin and subcutaneous tissue up to the presacral fascia guided by electrocautery was performed, followed by reconstruction of the defect by perforator-based Limberg flap (based on the superior gluteal and sacral perforators).
Primary healing occurred in 22 patients. Two patients (8%) had seroma with negative bacterial cultures, which healed completely with bedside drainage and conservative treatment. Another patient (4%) had superficial wound infection that were treated by appropriate antimicrobial therapy. Complete healing of all cases occurred without recurrence during the follow-up period. The mean operative time was 40min (ranging between 30 and 45min according to the size of the lesion). There was no ischaemia or necrosis of the flaps, and all flaps remained viable. The mean length of hospital stay was 2 days, ranging between 1 and 6 days.
The use of superiorly based Limberg flap in reconstruction after excision of sacrococcygeal pilonidal sinus is reliable, easily performed, associated with complete cure and low postoperative complications.
评价臀上动脉穿支蒂皮瓣（先前用于压疮重建）在切除骶尾部藏毛窦后重建中的应用。
2004 年 1 月至 2007 年 2 月，25 例年龄 14 至 29 岁（中位年龄：23 岁）的男性复发性藏毛窦患者接受 Limberg 皮瓣技术手术治疗。症状持续时间平均为 5.2 ± 4.5 年（范围 3-6 年）。在电灼引导下，对窦道皮肤和皮下组织进行菱形切除，直至骶前筋膜，然后采用基于穿支的 Limberg 皮瓣（基于臀上动脉和骶骨穿支）重建缺损。
22 例患者一期愈合。2 例（8%）患者出现血清肿，细菌培养阴性，经床边引流和保守治疗后完全愈合。另 1 例（4%）患者出现浅表伤口感染，经适当的抗菌治疗后治愈。所有病例均在随访期间完全愈合，无复发。手术时间平均为 40 分钟（根据病变大小在 30-45 分钟之间）。无皮瓣缺血或坏死，所有皮瓣均存活。平均住院时间为 2 天，范围为 1-6 天。
切除骶尾部藏毛窦后采用臀上动脉穿支蒂皮瓣重建是可靠的、易于操作的，可完全治愈且术后并发症低。
