Utility of methylene blue guided Limberg flap on long-term recurrence in adult chronic pilonidal disease

Aim: Pilonidal sinus is a chronic intermittent disease, usually involving the sacrococcygeal area. This study was undertaken to compare the long-term results of peroperative methylene blue use in patients with pilonidal disease who underwent Limberg flap technique with and without methylene blue application. Method: Patients who underwent Limberg flap for pilonidal sinus surgery between January 2014 and November 2018 were divided into two groups: methylene blue-guided surgery (group 1) and unguided surgery (group 2). Data of the patients were collected from the files, and the long-term recurrence data of the patients were obtained by one-to-one phone calls and outpatient controls at 36 months. Age and body mass index (BMI) were also evaluated. BMI of the patients was categorized as 18.1-20.0 kg/m2, 20.1-22.5 kg/m2, 22.6-25.0 kg/m2, 25.1-27.5 kg/m2, 27.6-30.0 kg/m2 and >30.1 kg/m2. Results: Methylene blue was performed in 62 of 100 patients who underwent Limberg flap procedure and there was one recurrence in both groups. Methylene blue application did not have an effect on long-term recurrence (p=0.98). BMI groups and recurrence were analyzed regardless of methylene blue use, and BMI greater than 27.5-30.0 kg/m2 was statistically significant in the development of recurrence in long-term results (p=0.040). Conclusion: Although it is considered as an integral part of pilonidal sinus surgery, there is no superiority of methylene blue guided surgery on longterm recurrences.