Limberg Flap Versus Karydakis Flap for Treating Pilonidal Sinus Disease: a Systematic Review and Meta-analysis

Overview

Journal Can J Surg

Specialty General Surgery

Date 2019 Jan 31

PMID 30697992

Citations 12

Authors

Paschalis Gavriilidis

Emil Bota

Affiliations

Soon will be listed here.

Abstract

Background: The Limberg flap reconstruction and the Karydakis flap reconstruction are the 2 most used off-midline closure techniques in pilonidal sinus surgery. The current evidence is inconclusive as to which is the optimal technique. The aim of this systematic review and meta-analysis was to compare differences in outcomes between these 2 flap-based techniques.

Methods: We identified studies by a systematic literature search of the Embase, MEDLINE (PubMed), Cochrane Library and Google Scholar databases and studies selected as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Only randomized controlled trials (RCTs) that compared the Limberg flap (standard or modified) and the Karydakis flap were included in this review.

Results: Operative time was shorter by 7 minutes in the Karydakis group than in the Limberg group (mean difference 7.00 min, 95% confidence interval [CI] 0.53 to 13.48). The seroma formation rate was significantly higher in the Karydakis cohort (odds ratio [OR] 0.36, 95% CI 0.24 to 0.56); however, after excluding studies with a high risk of bias, the sensitivity analysis showed no significant differences in seroma formation rate between the 2 techniques (OR 0.76, 95% CI 0.31 to 1.85). Other outcomes of interest showed no significant differences between the Limberg and Karydakis techniques.

Conclusion: There were no significant differences between the Limberg and Karydakis techniques. Future RCTs with strict adherence to CONSORT guidelines will further elucidate the efficacy of these surgical procedures.

Citing Articles

Comparative Outcomes of Surgical Techniques for Pilonidal Sinus: A Turkish Retrospective Study.

Gojayev A, Erkent M, Aydin H, Aydogan C, Avci T, Tirnova I Med Sci Monit. 2025; 31:e947466.

PMID: 39995244 PMC: 11871746. DOI: 10.12659/MSM.947466.

[Long-term results of a pilot study on a two-stage procedure with primary excision and Limberg flap in the interval for treatment of sacrococcygeal pilonidal sinus disease].

Ardelt M, Rauchfuss F, Dondorf F, Deeb A, Bauschke A, Rohland O Chirurgie (Heidelb). 2025; .

PMID: 39966137 DOI: 10.1007/s00104-025-02252-9.

A novel, double Limberg flap repair for recurrent pilonidal sinus disease.

Leung E, Finlayson A J Surg Case Rep. 2024; 2024(11):rjae683.

PMID: 39507353 PMC: 11539901. DOI: 10.1093/jscr/rjae683.

Pilonidal sinus: an overview of historical and current management modalities.

Tam A, Steen C, Chua J, Yap R Updates Surg. 2024; 76(3):803-810.

PMID: 38526695 PMC: 11129967. DOI: 10.1007/s13304-024-01799-2.

Comparison of laser ablation, simple excision, and flap reconstruction in the treatment of pilonidal sinus disease.

Tyrvainen E, Nuutinen H, Savikkomaa E, Myllykangas H Lasers Med Sci. 2024; 39(1):52.

PMID: 38291247 PMC: 10827894. DOI: 10.1007/s10103-024-03993-5.

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