It can be performed for the management of primary or recurrent pilonidal sinus, with a low complication rate, short hospital stay, short time to return to normal activity, and good long-term results. In the literature, this procedure has been shown to be superior to primary closure and other flaps.
#Bascom flap skin
Limberg flap reconstruction following rhomboid excision of the sinus area, involves closing a 60° rhombus-shaped defect with a transposition flap, with sutures away from the midline, giving rise to a tensionless flap of unscarred skin in the midline. The procedure can be used for primary or recurrent cases of SCPS. Bascom's cleft lift procedure involves only the excision of midline pits and scarred skin, avoiding removal of deep tissues, and places the incision sufficiently to the side so that it can heal well. The importance of avoiding midline incisions and placing any healing wounds off midline to reduce recurrence was recognized by Bascom. However, no single surgical procedure has been widely accepted as the gold standard for the treatment of SCPS. There are many different techniques for the treatment of sacrococcygeal pilonidal sinus (SCPS), ranging from open wound fistulotomy and curettage, marsupialization, midline excision and closure, asymmetric/oblique excision, and closure (Karydakis procedure, Bascom's procedure, cleft closure), to flaps (rhomboid, V–Y advancement, Z-plasty, gluteal myocutaneous). Pilonidal disease may arise in one of three forms: acute abscess, sinus tracts, or complex disease characterized by chronic or recurrent abscesses with extensive branching sinus tracts. It most often results from mechanical stretch, which causes enlargement and rupture of hair follicles in the natal cleft of the sacrococcygeal area. There are various theories on the predisposing factors and causes of the disease. Pilonodal disease occurs in ∼0.7% of the population, with the peak age of incidence being 16–25 years. ConclusionĪlthough Bascom's cleft lift operation involves a shorter duration of operation, the rhomboidshaped excision with the Limberg flap procedure was superior in terms of early wound healing, with similar incidences of wound-related complications and recurrence after treatment of primary SCPS. The incidences of postoperative wound-related complications and recurrence were 6 and 2%, respectively, after the Bascom's cleft lift procedure and 4 and 2%, respectively, after the rhomboid flap procedure, with insignificant differences. A significant clinical outcome was achieved after the rhomboid flap procedure in terms of less duration to pain relief (12.42 ± 1.59 vs. Compared with Bascom's cleft lift procedure, the rhomboid flap procedure involved a longer duration of operation (61.14 ± 16.36 vs. There were insignificant differences in the baseline characteristics between both groups. Through the follow-up period, which ranged from 6 to 12 months, with an average of 9.1 ± 1.7 months, patients were evaluated for wound-related complications and recurrence of symptoms after complete wound healing. This study included 100 adult patients with primary (nonrecurrent) SCPS who were randomized to Bascom's cleft lift procedure ( n = 50) or to rhomboid flap procedure (rhomboid-shaped excision and Limberg flap) ( n = 50). The aim of this study was to evaluate and compare clinical safety and efficacy after Bascom's cleft lift and rhomboid flap (Limberg) procedures for the treatment of primary sacrococcygeal pilonidal sinus (SCPS).