A Randomized Clinical Study Evaluating the Need for Drainage After Limberg Flap for Pilonidal Sinus

Background This prospective randomized clinical study was conducted to evaluate the need for drainage after rhomboid excision and a Limberg flap (RELIF) for the treatment of pilonidal sinus. Methods One hundred one patients undergoing the RELIF procedure were randomly treated with drainage or not. Operating time, postoperative pain assessed on a visual analogue scale (VAS), total amount of intramuscular analgesic administered, hospital stay, complications, recurrence rate, and patient satisfaction were assessed. Results The mean operating time ( P = 0.036), VAS scores on postoperative day 0 ( P = 0.039) and day 1 ( P = 0.006), intramuscular analgesic requirement ( P = 0.009), mean amount of intramuscular analgesic administered ( P = 0.025), complication rate ( P = 0.027), and mean hospital stay ( P = 0.0001) were significantly reduced in the non-drained group. The recurrence rate was similar in the two groups ( P = 0.32). Conclusions This study indicates that drain placement after the RELIF procedure might negatively affect the postoperative outcomes of patients with pilonidal sinus. On the basis of these finding, we suggest that the use of drains may not be necessary after the RELIF procedure for the treatment of pilonidal sinus.