{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:58:59Z","timestamp":1781873939228,"version":"3.54.5"},"reference-count":34,"publisher":"International College of Surgeons","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>The aim of this study was to evaluate the results of cases with pilonidal sinus (PS) disease that underwent Limberg flap (LF) transposition and to compare the short and long-term results of early discharge cases with those in the literature. A total of 345 patients who underwent rhomboid excision and LF transposition for PS were evaluated retrospectively. No major anesthetic or surgical complications occurred. Partial wound dehiscence, localized flap necrosis, hematoma, wound infection, and seroma rates were determined as 4.0, 2.1, 1.5, 3.3, and 3.7% respectively. All patients other than those with a hematoma or localized necrosis were discharged with a drain in place 24 hours after the operation. The recurrence rate was 3.9% after a mean 33.1-month follow-up (range, 6\u201372 months). As a result, we found that short and long-term results of patients who underwent LF and were discharged 24 hours after the operation were similar to those in the literature. We suggest that patients without postoperative complications, such as hematoma or flap necrosis, can be discharged early.<\/jats:p>","DOI":"10.9738\/intsurg-d-13-00150.1","type":"journal-article","created":{"date-parts":[[2014,1,20]],"date-time":"2014-01-20T22:47:19Z","timestamp":1390258039000},"page":"28-34","source":"Crossref","is-referenced-by-count":12,"title":["Retrospective Review of Pilonidal Sinus Patients With Early Discharge After Limberg Flap Procedure"],"prefix":"10.9738","volume":"99","author":[{"given":"Fatih","family":"Altintoprak","sequence":"first","affiliation":[{"name":"Sakarya University Faculty of Medicine, Department of General Surgery, Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Gundogdu","sequence":"additional","affiliation":[{"name":"Sakarya University Research and Educational Hospital, Department of General Surgery, Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tolga","family":"Ergonenc","sequence":"additional","affiliation":[{"name":"Sakarya University Research and Educational Hospital, Department of Anesthesiology, Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enis","family":"Dikicier","sequence":"additional","affiliation":[{"name":"Sakarya University Research and Educational Hospital, Department of General Surgery, Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guner","family":"Cakmak","sequence":"additional","affiliation":[{"name":"Sakarya University Research and Educational Hospital, Department of General Surgery, Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fehmi","family":"Celebi","sequence":"additional","affiliation":[{"name":"Sakarya University Faculty of Medicine, Department of General Surgery, Sakarya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4721","reference":[{"issue":"2","key":"i0020-8868-99-1-28-b01","series-title":"Dis Colon Rectum","first-page":"233","article-title":"Limberg flap repair for pilonidal sinus disease","volume":"47","author":"Daphan\n              C,","year":"2004","unstructured":"Daphan\n              C, \n            \n              Tekelioglu\n              MH, \n            \n              Sayilgan\n              C. \n          \n          Limberg flap repair for pilonidal sinus disease. Dis Colon Rectum2004;47(2):233\u2013237"},{"issue":"3","key":"i0020-8868-99-1-28-b02","series-title":"Am J Surg","first-page":"388","article-title":"Does technique alter quality of life after pilonidal sinus surgery?","volume":"190","author":"Ertan\n              T,","year":"2005","unstructured":"Ertan\n              T, \n            \n              Koc\n              M, \n            \n              Gocmen\n              E, \n            \n              Aslar\n              AK, \n            \n              Keskek\n              M, \n            \n              Kilic\n              M. \n          \n          Does technique alter quality of life after pilonidal sinus surgery?\n          Am J Surg\n          2005;190(3):388\u2013392"},{"issue":"10","key":"i0020-8868-99-1-28-b03","series-title":"Acta Chir Scand","first-page":"695","article-title":"Primary closure or secondary granulation after excision of pilonidal sinus?","volume":"156","author":"al-Hassan\n              HK,","year":"1990","unstructured":"al-Hassan\n              HK, \n            \n              Francis\n              IM, \n            \n              Neglen\n              P. \n          \n          Primary closure or secondary granulation after excision of pilonidal sinus?\n          Acta Chir Scand\n          1990;156(10):695\u2013699"},{"issue":"5","key":"i0020-8868-99-1-28-b04","series-title":"Dis Colon Rectum","first-page":"656","article-title":"Rhomboid excision and Limberg flap for managing pilonidal sinus: results of 102 cases","volume":"45","author":"Urhan\n              M,","year":"2002","unstructured":"Urhan\n              M, \n            \n              K\u00fcc\u00fckel\n              F, \n            \n              Topg\u00fcl\n              K, \n            \n              Ozer\n              I, \n            \n              Sari\n              S. \n          \n          Rhomboid excision and Limberg flap for managing pilonidal sinus: results of 102 cases. Dis Colon Rectum2002;45(5):656\u2013659"},{"issue":"6","key":"i0020-8868-99-1-28-b05","series-title":"Acta Chir Scand","first-page":"537","article-title":"Simple primary closure for pilonidal disease","volume":"136","author":"Holm\n              J,","year":"1970","unstructured":"Holm\n              J, \n            \n              Hulten\n              L. \n          \n          Simple primary closure for pilonidal disease. Acta Chir Scand1970;136(6):537\u2013540"},{"issue":"5","key":"i0020-8868-99-1-28-b06","series-title":"World J Surg","first-page":"1064","article-title":"Outcome of the rhomboid flap for recurrent pilonidal disease","volume":"33","author":"el-Khadrawy\n              O,","year":"2009","unstructured":"el-Khadrawy\n              O, \n            \n              Hashish\n              M, \n            \n              Ismail\n              K, \n            \n              Shalaby\n              H. \n          \n          Outcome of the rhomboid flap for recurrent pilonidal disease. World J Surg2009;33(5):1064\u20131068"},{"issue":"1","key":"i0020-8868-99-1-28-b07","series-title":"Clin Colon Rectal Surg","first-page":"46","article-title":"Pilonidal disease","volume":"24","author":"Khanna\n              A,","year":"2011","unstructured":"Khanna\n              A, \n            \n              Rombeau\n              JL. \n          \n          Pilonidal disease. Clin Colon Rectal Surg2011;24(1):46\u201353"},{"issue":"12","key":"i0020-8868-99-1-28-b08","series-title":"World J Surg","first-page":"2261","article-title":"Multiple Z-plasty in pilonidal sinus\u2013a new technique under local anesthesia","volume":"30","author":"Sharma\n              PP.","year":"2006","unstructured":"Sharma\n              PP. \n          \n          Multiple Z-plasty in pilonidal sinus\u2013a new technique under local anesthesia. 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Langenbecks Arch Surg2008;393(2):185\u2013189"},{"issue":"11","key":"i0020-8868-99-1-28-b13","series-title":"Dis Colon Rectum","first-page":"1545","article-title":"Long-term results of Limberg flap procedure for treatment of pilonidal sinus: a report of 200 cases","volume":"46","author":"Topg\u00fcl\n              K,","year":"2003","unstructured":"Topg\u00fcl\n              K, \n            \n              Ozdemir\n              E, \n            \n              Kilic\n              K, \n            \n              G\u00f6kbayir\n              H, \n            \n              Ferahk\u00f6\u015fe\n              Z. \n          \n          Long-term results of Limberg flap procedure for treatment of pilonidal sinus: a report of 200 cases. Dis Colon Rectum2003;46(11):1545\u20131548"},{"issue":"4","key":"i0020-8868-99-1-28-b14","series-title":"Ind J Surg","first-page":"298","article-title":"Limberg flap for sacrococcygeal pilonidal sinus a safe and sound procedure","volume":"75","author":"Aithal\n              SK,","year":"2013","unstructured":"Aithal\n              SK, \n            \n              Rajan\n              CS, \n            \n              Reddy\n              N. \n          \n          Limberg flap for sacrococcygeal pilonidal sinus a safe and sound procedure. Ind J Surg2013;75(4):298\u2013301"},{"issue":"9","key":"i0020-8868-99-1-28-b15","series-title":"Dis Colon Rectum","first-page":"1436","article-title":"Lower recurrence rate for Limberg vs. V-Y flap for pilonidal sinus","volume":"50","author":"Unalp\n              HR,","year":"2007","unstructured":"Unalp\n              HR, \n            \n              Derici\n              H, \n            \n              Kamer\n              E, \n            \n              Nazli\n              O, \n            \n              Onal\n              MA. \n          \n          Lower recurrence rate for Limberg vs. V-Y flap for pilonidal sinus. Dis Colon Rectum2007;50(9):1436\u20131444"},{"issue":"2","key":"i0020-8868-99-1-28-b16","series-title":"World J Surg","first-page":"431","article-title":"Comparison of Limberg flap and tension-free primary closure during pilonidal sinus surgery","volume":"36","author":"Oku\u015f\n              A,","year":"2012","unstructured":"Oku\u015f\n              A, \n            \n              Sevin\u00e7\n              B, \n            \n              Karahan\n              O, \n            \n              Eryilmaz\n              MA. \n          \n          Comparison of Limberg flap and tension-free primary closure during pilonidal sinus surgery. World J Surg2012;36(2):431\u2013435"},{"issue":"7","key":"i0020-8868-99-1-28-b17","series-title":"Colorectal Dis","first-page":"705","article-title":"Comparison of the short-term results after Limberg and Karydakis procedures for pilonidal disease: randomized prospective analysis of 100 patients","volume":"11","author":"Ersoy\n              E,","year":"2009","unstructured":"Ersoy\n              E, \n            \n              Devay\n              AO, \n            \n              Aktimur\n              R, \n            \n              Doganay\n              B, \n            \n              Ozdo\u011fan\n              M, \n            \n              G\u00fcndogdu\n              RH. \n          \n          Comparison of the short-term results after Limberg and Karydakis procedures for pilonidal disease: randomized prospective analysis of 100 patients. Colorectal Dis2009;11(7):705\u2013710"},{"issue":"11","key":"i0020-8868-99-1-28-b18","series-title":"Dis Colon Rectum","first-page":"1427","article-title":"Are postoperative drains necessary with the Limberg flap for treatment of pilonidal sinus?","volume":"41","author":"Erdem\n              E,","year":"1998","unstructured":"Erdem\n              E, \n            \n              Sungurtekin\n              U, \n            \n              Ne\u015f\u015far\n              M. \n          \n          Are postoperative drains necessary with the Limberg flap for treatment of pilonidal sinus?\n          Dis Colon Rectum\n          1998;41(11):1427\u20131431"},{"issue":"4","key":"i0020-8868-99-1-28-b19","series-title":"Tech Coloproctol","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s10151-011-0782-5","article-title":"The effects of drainage on the rates of early wound complications and recurrences after Limberg flap reconstruction in patients with pilonidal disease","volume":"15","author":"Kirkil\n              C,","year":"2011","unstructured":"Kirkil\n              C, \n            \n              B\u00f6y\u00fck\n              A, \n            \n              B\u00fclb\u00fcller\n              N, \n            \n              Aygen\n              E, \n            \n              Karabulut\n              K, \n            \n              Co\u015fkun\n              S. \n          \n          The effects of drainage on the rates of early wound complications and recurrences after Limberg flap reconstruction in patients with pilonidal disease. Tech Coloproctol2011;15(4):425\u2013429 DOI:10.1007\/s10151-011-0782-5."},{"issue":"1","key":"i0020-8868-99-1-28-b20","series-title":"Tech Coloproctol","first-page":"27","article-title":"Sacrococcygeal pilonidal sinus disease with Limberg flap repair","volume":"6","author":"Kapan\n              M,","year":"2002","unstructured":"Kapan\n              M, \n            \n              Kapan\n              S, \n            \n              Pekmezci\n              S, \n            \n              Durgun\n              V. \n          \n          Sacrococcygeal pilonidal sinus disease with Limberg flap repair. Tech Coloproctol2002;6(1):27\u201332"},{"issue":"3","key":"i0020-8868-99-1-28-b21","series-title":"Int J Colorectal Dis","first-page":"173","article-title":"The role of obesity on the recurrence of pilonidal sinus disease in patients, who were treated by excision and Limberg flap transposition","volume":"15","author":"Cubuk\u00e7u\n              A,","year":"2000","unstructured":"Cubuk\u00e7u\n              A, \n            \n              G\u00f6n\u00fcll\u00fc\n              NN, \n            \n              Paksoy\n              M, \n            \n              Alponat\n              A, \n            \n              Kuru\n              M, \n            \n              Ozbay\n              O. \n          \n          The role of obesity on the recurrence of pilonidal sinus disease in patients, who were treated by excision and Limberg flap transposition. Int J Colorectal Dis. 2000;15(3):173\u2013175"},{"issue":"4","key":"i0020-8868-99-1-28-b22","series-title":"Ind J Surg","first-page":"305","article-title":"Elliptical excision with midline primary closure versus rhomboid excision with Limberg flap reconstruction in sacrococcygeal pilonidal disease: a prospective, randomized study","volume":"74","author":"Dass\n              TA,","year":"2012","unstructured":"Dass\n              TA, \n            \n              Zaz\n              M, \n            \n              Rather\n              A, \n            \n              Bari\n              S. \n          \n          Elliptical excision with midline primary closure versus rhomboid excision with Limberg flap reconstruction in sacrococcygeal pilonidal disease: a prospective, randomized study. Ind J Surg2012;74(4):305\u2013308"},{"issue":"9","key":"i0020-8868-99-1-28-b23","series-title":"Br J Surg","first-page":"1081","article-title":"Randomized clinical trial comparing primary closure with the Limberg flap in the treatment of primary sacrococcygeal pilonidal disease","volume":"92","author":"Akca\n              T,","year":"2005","unstructured":"Akca\n              T, \n            \n              Colak\n              T, \n            \n              Ustunsoy\n              B, \n            \n              Kanik\n              A, \n            \n              Aydin\n              S. \n          \n          Randomized clinical trial comparing primary closure with the Limberg flap in the treatment of primary sacrococcygeal pilonidal disease. Br J Surg2005;92(9):1081\u20131084"},{"issue":"5","key":"i0020-8868-99-1-28-b24","series-title":"Am J Surg","first-page":"568","article-title":"Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study","volume":"202","author":"Ates\n              M,","year":"2011","unstructured":"Ates\n              M, \n            \n              Dirican\n              A, \n            \n              Sarac\n              M, \n            \n              Aslan\n              A, \n            \n              Colak\n              C. \n          \n          Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study. Am J Surg2011;202(5):568\u2013573"},{"issue":"1","key":"i0020-8868-99-1-28-b25","series-title":"Surgeon","first-page":"7","article-title":"Outcome of treatment of primary and recurrent pilonidal sinuses with the Limberg flap","volume":"4","author":"Katsoulis\n              IE,","year":"2006","unstructured":"Katsoulis\n              IE, \n            \n              Hibberts\n              F, \n            \n              Carapeti\n              EA. \n          \n          Outcome of treatment of primary and recurrent pilonidal sinuses with the Limberg flap. Surgeon2006;4(1):7\u201310"},{"issue":"6","key":"i0020-8868-99-1-28-b26","series-title":"Dis Colon Rectum","first-page":"775","article-title":"Management of pilonidal sinus with the Limberg flap","volume":"41","author":"Bozkurt\n              MK,","year":"1998","unstructured":"Bozkurt\n              MK, \n            \n              Tezel\n              E. \n          \n          Management of pilonidal sinus with the Limberg flap. Dis Colon Rectum1998;41(6):775\u2013777"},{"issue":"8","key":"i0020-8868-99-1-28-b27","series-title":"Surgery Today","first-page":"757","article-title":"Comparison of the classic Limberg flap and modified Limberg flap in the treatment of pilonidal sinus disease: a retrospective analysis of 416 patients","volume":"40","author":"Akin\n              M,","year":"2010","unstructured":"Akin\n              M, \n            \n              Leventoglu\n              S, \n            \n              Mentes\n              BB, \n            \n              Bostanci\n              H, \n            \n              Gokbayir\n              H, \n            \n              Kilic\n              K. \n          \n          Comparison of the classic Limberg flap and modified Limberg flap in the treatment of pilonidal sinus disease: a retrospective analysis of 416 patients. Surgery Today2010;40(8):757\u2013762"},{"issue":"1","key":"i0020-8868-99-1-28-b28","series-title":"Am J Surg","first-page":"9","article-title":"Randomized comparison of Limberg flap versus modified primary closure for the treatment of pilonidal disease","volume":"200","author":"Muzi\n              MG,","year":"2010","unstructured":"Muzi\n              MG, \n            \n              Milito\n              G, \n            \n              Cadeddu\n              F, \n            \n              Nigro\n              C, \n            \n              Andreoli\n              F, \n            \n              Amabile\n              D. \n          \n          Randomized comparison of Limberg flap versus modified primary closure for the treatment of pilonidal disease. Am J Surg2010;200(1): 9\u201314"},{"issue":"5","key":"i0020-8868-99-1-28-b29","series-title":"Surgery","first-page":"745","article-title":"Surgical treatment of sacrococcygeal pilonidal sinus with the Limberg transposition flap","volume":"134","author":"Eryilmaz\n              R,","year":"2003","unstructured":"Eryilmaz\n              R, \n            \n              Sahin\n              M, \n            \n              Alimoglu\n              O, \n            \n              Dasiran\n              F. \n          \n          Surgical treatment of sacrococcygeal pilonidal sinus with the Limberg transposition flap. Surgery2003;134(5):745\u2013749"},{"issue":"9","key":"i0020-8868-99-1-28-b30","series-title":"Colorectal Dis","first-page":"945","article-title":"Rhomboid excision and Limberg flap for managing pilonidal sinus: long-term results in 411 patients","volume":"10","author":"Akin\n              M,","year":"2008","unstructured":"Akin\n              M, \n            \n              Gokbayir\n              H, \n            \n              Kilic\n              K, \n            \n              Topgul\n              K, \n            \n              Ozdemir\n              E, \n            \n              Ferahkose\n              Z. \n          \n          Rhomboid excision and Limberg flap for managing pilonidal sinus: long-term results in 411 patients. Colorectal Dis2008;10(9):945\u2013948"},{"issue":"3","key":"i0020-8868-99-1-28-b31","series-title":"Indian J Surg","first-page":"192","article-title":"Limberg flap versus primary closure in the treatment of primary sacrococcygeal pilonidal disease: a randomized clinical trial","volume":"75","author":"Khan\n              PS,","year":"2013","unstructured":"Khan\n              PS, \n            \n              Hayat\n              H, \n            \n              Hayat\n              G. \n          \n          Limberg flap versus primary closure in the treatment of primary sacrococcygeal pilonidal disease: a randomized clinical trial. Indian J Surg2013;75(3):192\u2013194"},{"issue":"1","key":"i0020-8868-99-1-28-b32","series-title":"Scand J Surg","first-page":"43","article-title":"Surgery for pilonidal disease","volume":"94","author":"H\u00f8lmebakk\n              T,","year":"2005","unstructured":"H\u00f8lmebakk\n              T, \n            \n              Nesbakken\n              A. \n          \n          Surgery for pilonidal disease. Scand J Surg2005;94(1): 43\u201346"},{"issue":"2","key":"i0020-8868-99-1-28-b33","series-title":"Colorectal Dis","first-page":"143","article-title":"Primary closure or rhomboid excision and Limberg flap for the management of primary sacrococcygeal pilonidal disease? A meta-analysis of randomized controlled trials","volume":"14","author":"Horwood\n              J,","year":"2012","unstructured":"Horwood\n              J, \n            \n              Hanratty\n              D, \n            \n              Chandran\n              P, \n            \n              Billings\n              P. \n          \n          Primary closure or rhomboid excision and Limberg flap for the management of primary sacrococcygeal pilonidal disease? A meta-analysis of randomized controlled trials. Colorectal Dis2012;14(2):143\u2013152"},{"key":"i0020-8868-99-1-28-b34","series-title":"Colorectal Dis","first-page":"205","article-title":"Pilonidal sinus: is surgery alone enough?","volume":"5","year":"2003","unstructured":"Editorial. Pilonidal sinus: is surgery alone enough?Colorectal Dis2003;5:205"}],"container-title":["International Surgery"],"original-title":[],"link":[{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/99\/1\/article-p28.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/international-surgery\/article-pdf\/99\/1\/28\/2213815\/intsurg-d-13-00150_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/99\/1\/article-p28.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/99\/1\/article-p28.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T19:08:54Z","timestamp":1751483334000},"score":1,"resource":{"primary":{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/99\/1\/article-p28.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":34,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.9738\/intsurg-d-13-00150.1","relation":{},"ISSN":["0020-8868","2520-2456"],"issn-type":[{"value":"0020-8868","type":"print"},{"value":"2520-2456","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014]]}}}