Effectiveness of Platelet-rich Plasma Therapy and Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Prospective Observational Study

Introduction: Pilonidal Sinus Disease (PSD) is a chronic inflammatory condition affecting the sacrococcygeal region, commonly seen in young adults. The ideal treatment remains debated, with surgical techniques such as Limberg flap reconstruction and non surgical approaches like Platelet-Rich Plasma...

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Main Authors: S Vinith Balaji, K Thinagaran, Reegan Jose, Najeem Fazil, Mohana Vamsi, Arafath Iqbal
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-07-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=July&volume=19&issue=7&page=PC10-PC14&id=21247
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author S Vinith Balaji
K Thinagaran
Reegan Jose
Najeem Fazil
Mohana Vamsi
Arafath Iqbal
author_facet S Vinith Balaji
K Thinagaran
Reegan Jose
Najeem Fazil
Mohana Vamsi
Arafath Iqbal
author_sort S Vinith Balaji
collection DOAJ
description Introduction: Pilonidal Sinus Disease (PSD) is a chronic inflammatory condition affecting the sacrococcygeal region, commonly seen in young adults. The ideal treatment remains debated, with surgical techniques such as Limberg flap reconstruction and non surgical approaches like Platelet-Rich Plasma (PRP) therapy being explored for their efficacy in reducing recurrence and improving wound healing. Aim: To compare the wound healing duration, postoperative pain levels, recurrence rates and postoperative complications between PRP therapy and Limberg flap reconstruction in the management of PSD. Materials and Methods: A prospective observational study was conducted in the Department of General Surgery at SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India from January to December 2024, involving 62 patients. Adults aged 18 to 65 years with Type I or II PSD, who were fit for surgery and willing to provide informed consent, were included. Patients were randomly allocated into two groups: Group A (PRP Therapy, n=31) and Group B (Limberg Flap Reconstruction, n=31). In Group A, PRP was applied both intraoperatively and during the postoperative follow-up, while Group B underwent excision followed by flap reconstruction using the Limberg flap technique. Data on key outcomes, including wound healing time, pain levels {measured using the Visual Analog Scale (VAS)}, recurrence rates and postoperative complications, were collected over a 6-month period. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS) version 29.0, with a p-value <0.05 considered statistically significant. Results: The mean wound healing duration was significantly shorter in Group A (29.0±7.0 days) compared to Group B (39.0±8.0 days, p-value <0.001). Pain scores (VAS) were similar on Day 2 (p-value=0.358), but Group A experienced significantly less pain from Day 3 onwards (p-value<0.05). Recurrence rates were significantly lower in Group A {4 (12.9%)} compared to Group B {10 (32.3%), p-value=0.029}. Postoperative complications were less frequent in Group A {24 (77.4%) had no complications vs. 19 (61.3%) in Group B, p=0.045}, with Group B showing higher rates of seroma formation {5 (16.1%) vs. 3 (9.7%)} and wound dehiscence {4 (12.9%) vs. 1 (3.2%)}. Infection rates were similar in both groups, at 3 (9.7%). Conclusion: PRP therapy presents a promising and effective alternative for managing PSD, potentially enhancing recovery and minimising complications.
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spelling doaj-art-4e501ff5bb6b45808a925e84bb1684822025-08-20T03:13:54ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-07-01197PC10PC1410.7860/JCDR/2025/78621.21247Effectiveness of Platelet-rich Plasma Therapy and Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Prospective Observational StudyS Vinith Balaji0K Thinagaran1Reegan Jose2Najeem Fazil3Mohana Vamsi4Arafath Iqbal5Junior Resident, Department of General Surgery, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India.Professor and Head, Department of General Surgery, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India.Assistant Professor, Department of General Surgery, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India.Assistant Professor, Department of General Surgery, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India.Junior Resident, Department of General Surgery, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India.Junior Resident, Department of General Surgery, SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India.Introduction: Pilonidal Sinus Disease (PSD) is a chronic inflammatory condition affecting the sacrococcygeal region, commonly seen in young adults. The ideal treatment remains debated, with surgical techniques such as Limberg flap reconstruction and non surgical approaches like Platelet-Rich Plasma (PRP) therapy being explored for their efficacy in reducing recurrence and improving wound healing. Aim: To compare the wound healing duration, postoperative pain levels, recurrence rates and postoperative complications between PRP therapy and Limberg flap reconstruction in the management of PSD. Materials and Methods: A prospective observational study was conducted in the Department of General Surgery at SRM Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India from January to December 2024, involving 62 patients. Adults aged 18 to 65 years with Type I or II PSD, who were fit for surgery and willing to provide informed consent, were included. Patients were randomly allocated into two groups: Group A (PRP Therapy, n=31) and Group B (Limberg Flap Reconstruction, n=31). In Group A, PRP was applied both intraoperatively and during the postoperative follow-up, while Group B underwent excision followed by flap reconstruction using the Limberg flap technique. Data on key outcomes, including wound healing time, pain levels {measured using the Visual Analog Scale (VAS)}, recurrence rates and postoperative complications, were collected over a 6-month period. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS) version 29.0, with a p-value <0.05 considered statistically significant. Results: The mean wound healing duration was significantly shorter in Group A (29.0±7.0 days) compared to Group B (39.0±8.0 days, p-value <0.001). Pain scores (VAS) were similar on Day 2 (p-value=0.358), but Group A experienced significantly less pain from Day 3 onwards (p-value<0.05). Recurrence rates were significantly lower in Group A {4 (12.9%)} compared to Group B {10 (32.3%), p-value=0.029}. Postoperative complications were less frequent in Group A {24 (77.4%) had no complications vs. 19 (61.3%) in Group B, p=0.045}, with Group B showing higher rates of seroma formation {5 (16.1%) vs. 3 (9.7%)} and wound dehiscence {4 (12.9%) vs. 1 (3.2%)}. Infection rates were similar in both groups, at 3 (9.7%). Conclusion: PRP therapy presents a promising and effective alternative for managing PSD, potentially enhancing recovery and minimising complications.https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=July&volume=19&issue=7&page=PC10-PC14&id=21247postoperative complicationsrecurrencewound healing
spellingShingle S Vinith Balaji
K Thinagaran
Reegan Jose
Najeem Fazil
Mohana Vamsi
Arafath Iqbal
Effectiveness of Platelet-rich Plasma Therapy and Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Prospective Observational Study
Journal of Clinical and Diagnostic Research
postoperative complications
recurrence
wound healing
title Effectiveness of Platelet-rich Plasma Therapy and Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Prospective Observational Study
title_full Effectiveness of Platelet-rich Plasma Therapy and Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Prospective Observational Study
title_fullStr Effectiveness of Platelet-rich Plasma Therapy and Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Prospective Observational Study
title_full_unstemmed Effectiveness of Platelet-rich Plasma Therapy and Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Prospective Observational Study
title_short Effectiveness of Platelet-rich Plasma Therapy and Limberg Flap Reconstruction in the Management of Pilonidal Sinus Disease: A Prospective Observational Study
title_sort effectiveness of platelet rich plasma therapy and limberg flap reconstruction in the management of pilonidal sinus disease a prospective observational study
topic postoperative complications
recurrence
wound healing
url https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=July&volume=19&issue=7&page=PC10-PC14&id=21247
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