Impact of fibrin sealant on Limberg flap technique: results of a randomized controlled trial

Abstract

Background: Pilonidal disease is a common chronic disorder mainly seen in the sacrococcygeal region, especially in young males. Different surgical methods have been described for the treatment. Limberg flap has low morbidity and recurrence rates. Fibrin sealant, a two-component tissue adhesive composed of fibrinogen and thrombin, has been used in a number of surgical procedures to achieve hemostasis and to seal tissues. The purpose of this study was to investigate the impact of fibrin sealant on the Limberg flap procedure.

Methods: Between January 2003 and January 2004, 32 male patients with pilonidal disease were randomly assigned to receive the standard Limberg flap technique (n=16) alone or with fibrin sealant application (n=16) before drain insertion.

Results: The two groups were similar for age and body mass index. The total drainage volume was 64.4+/-28.0 ml in the control group and 16.2+/-13.6 ml in the fibrin sealant group (p<0.001). Moreover, hospitalization time was 3.9+/-0.6 days in the control group and 2.0+/-0 days in the fibrin sealant group (p<0.001).

Conclusions: Use of fibrin sealant for Limberg flap technique shortens hospitalization time, reduces drainage volume and is therefore recommended.