Department of Surgery, District Hospital of St. Gallen, St. Gallen, Switzerland.
Dis Colon Rectum. 2011 Apr;54(4):487-94. doi: 10.1007/DCR.0b013e3182051d96.
Recent studies have reported excellent healing and low recurrence rates for rhomboid flaps for pilonidal sinus disease. The cosmetic outcome has been less investigated and is the focus of this study following Limberg flap reconstruction of recurrent and complex pilonidal disease.
From August 2006 to December 2007 patients with a recurrent or complex pilonidal sinus were enrolled consecutively. All underwent excision and closure with a Limberg flap. At 3 weeks, morbidity was assessed in the outpatient clinic. Recurrence rate, self-esteem, cosmetic outcome, body image, and patient satisfaction were analyzed prospectively at 1 year.
Seventy patients (57 males) with a median age of 24.8 years (range, 14.7-46.5) were operated on. Median follow-up was 1.4 years (range, 1.0-2.8). The mean cosmetic score was reduced to 16.4 (± 4.3) of 24, the mean body image score was good with 17.9 (± 2.6) of 20, and the mean overall satisfaction was high at 7.6 (± 2.3) of 10. Self-esteem remained unchanged after surgery; it was 7.8 (± 2.3) preoperatively and 7.8 (± 2.1) postoperatively (P = .818). After 3 weeks 84.3% of the wounds were completely healed. Complications occurred in 18 patients (25.7%), including superficial infection and partial suture dehiscence. Six (8.6%) needed reoperation, and all belonged to the group with acute infection before flap closure (P < .001). There was no incidence of flap necrosis. The recurrence rate was 1.6% at 1-year follow-up.
Initial wound closure and low recurrence rates after treatment with Limberg flap in pilonidal sinus disease lead to high patient satisfaction. The cosmetic outcome is acceptable, but an issue for some patients. These results support the use of the Limberg flap in complex pilonidal sinus disease after carefully informing patients about the cosmetic consequences.
最近的研究报道菱形皮瓣治疗藏毛窦疾病具有良好的愈合效果和较低的复发率。然而，其美容效果的研究相对较少，本研究重点关注 Limberg 皮瓣修复复发性和复杂性藏毛窦疾病的美容效果。
2006 年 8 月至 2007 年 12 月，连续纳入患有复发性或复杂性藏毛窦的患者。所有患者均接受切除和 Limberg 皮瓣闭合术。在门诊 3 周时评估发病率。前瞻性分析 1 年时的复发率、自尊、美容效果、身体形象和患者满意度。
70 例（57 例男性）患者的中位年龄为 24.8 岁（范围，14.7-46.5）。中位随访时间为 1.4 年（范围，1.0-2.8）。平均美容评分从术前的 24 分降至 16.4 分（±4.3），平均身体形象评分为 20 分中的 17.9 分（±2.6），总体满意度平均为 10 分中的 7.6 分（±2.3）。术后自尊无变化；术前为 7.8（±2.3）分，术后为 7.8（±2.1）分（P=.818）。术后 3 周时，84.3%的伤口完全愈合。18 例（25.7%）患者出现并发症，包括浅表感染和部分缝线裂开。6 例（8.6%）需要再次手术，均属于皮瓣闭合前急性感染组（P <.001）。无皮瓣坏死发生。1 年随访时的复发率为 1.6%。
Limberg 皮瓣治疗藏毛窦疾病后，初始伤口闭合和低复发率可带来较高的患者满意度。美容效果可接受，但对部分患者而言仍是一个问题。这些结果支持在仔细告知患者美容后果的情况下，在复杂的藏毛窦疾病中使用 Limberg 皮瓣。
