Sinus Laser Closure (SiLaC) with pit excision versus Limberg Flap in pilonidal disease: A prospective, randomized study

Pilonidal disease is a chronic suppurative condition of the natal cleft associated with significant morbidity primarily affecting the working population causing daily discomfort and activity limitation. Although several treatment modalities have been suggested for the management of this condition, the gold standard continues to be undefined. We conducted a randomized prospective study on the treatment of Pilonidal disease by Sinus Laser Closure (SiLaC) compared with Limberg Flap. 100 patients with primary Pilonidal disease were randomized to undergo either SiLaC or Limberg Flap. The primary objective of our study was to establish the advantage of SiLaC over Limberg Flap in terms of the operative time, postoperative pain, duration of hospital stay, healing time, cosmesis and recurrence rates over a period of 2 years. The patient satisfaction and return to normal activities were also documented. We analysed a total of 50 cases that underwent SiLaC and 50 that underwent Limberg Flap with similar demographic characteristics. Significantly lower operative time was noted in the SiLaC group. SiLaC was associated with decreased postoperative pain and duration of hospital stay with faster healing and better cosmetic outcome. The patient satisfaction and return to normal activites were also reported to be better in the SiLaC group. Recurrence was reported in 4 patients in SiLaC group versus 6 patients in Limberg Flap group. Our study reports SiLaC as superior to Limberg Flap with shorter operative time, lower pain scores, length of hospital stay, faster healing time, decreased recurrence rates and good cosmetic satisfaction.