✦ ROTATIONAL FLAP REPAIR

Limberg Flap (Rhomboid Flap)

Q: Is the Limberg Flap suitable for first-time pilonidal sinus?

Yes - particularly for large primary sinuses or patients with deep natal cleft anatomy. For smaller primary sinuses, Karydakis Flap or pit picking may be preferred.

Q: Is recovery from Limberg Flap longer than Karydakis?

Recovery times are similar - 3-4 weeks for primary wound healing. The Limberg Flap involves slightly more tissue mobilisation and donor site management.

Q: What are the risks of the Limberg Flap?

Flap complications (wound dehiscence, superficial skin necrosis at the flap tip) occur in approximately 5-10% of cases. These are usually minor and managed with local wound care.

Q: Is Limberg Flap pilonidal sinus surgery available in Hyderabad?

Yes - Dr. Samhitha Reddy performs Limberg Flap surgery at Lux Hospitals, Hyderabad as part of the complete pilonidal sinus reconstruction programme.

A rhomboid-shaped transposition flap reconstructs the natal cleft after wide excision of pilonidal sinus - effective for large defects, complex disease, or recurrence after prior surgery. Available at Lux Hospitals, Hyderabad.

<5% RECURRENCE RATE

3-4 Weeks RECOVERY

Large Defects RECONSTRUCTED

Recurrent DISEASE OPTION

What is Limberg Flap (Rhomboid Flap)?

The Limberg Flap (Rhomboid Transposition Flap) transposes a rhomboid-shaped flap of skin and subcutaneous tissue from an adjacent area to fill the surgical defect after wide pilonidal sinus excision - closing it under no tension with the scar placed completely off the midline. Dr. Samhitha Reddy uses the Limberg Flap at Lux Hospitals, Hyderabad for complex primary pilonidal disease with large defects, recurrent disease after prior excision, and cases where the Karydakis Flap does not provide adequate tissue. As part of the advanced pilonidal sinus treatment surgery in Hyderabad programme, it provides excellent tissue volume and reliable off-midline closure.

The Limberg Flap provides excellent tissue volume for larger defects but requires more tissue mobilisation than Karydakis. Active infection must be resolved before flap surgery.

How the Procedure Works

Rhomboid Excision Design

The sinus and all surrounding affected tissue is excised as a rhomboid block. A matching rhomboid flap is designed on the lateral buttock.

Wide Excision

The entire sinus, all pits, tracts, and affected tissue is excised down to the presacral fascia with all margins confirmed clear.

Flap Elevation

The rhomboid transposition flap is elevated with full-thickness skin and subcutaneous fat, preserving adequate subcutaneous tissue depth for blood supply.

Flap Transposition

The flap is rotated into the defect and sutured in place - deep layer with absorbable sutures, skin with interrupted sutures. Suction drain placed.

Donor Site Closure

The donor site is closed directly. Patient is mobilised carefully the next day. Drain removed at 24-48 hours.

Outcomes

<5%RECURRENCE RATE

3-4 WeeksRECOVERY

Large DefectsRECONSTRUCTED

RecurrentDISEASE OPTION

Who Needs This Treatment?

→Provides abundant well-vascularised tissue for large defect closure
→Places the wound scar completely off the midline - minimal recurrence risk
→Effective for recurrent disease where prior surgery has depleted local tissue options
→Primary closure - heals in 3-4 weeks rather than the 6-8 weeks of open excision
→Very low recurrence rate (<5%) in properly selected cases
→Available at Lux Hospitals, Hyderabad as part of the comprehensive pilonidal sinus reconstruction programme

The Limberg Flap is a beautifully versatile reconstructive option. Its rhomboid geometry provides generous well-vascularised tissue, and the transposition reliably moves the wound away from the problem midline - making it particularly valuable for the challenging recurrent pilonidal cases.

— - Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon

Common Questions

Frequently Asked

Is the Limberg Flap suitable for first-time pilonidal sinus?+

Is recovery from Limberg Flap longer than Karydakis?+

What are the risks of the Limberg Flap?+

Is Limberg Flap pilonidal sinus surgery available in Hyderabad?+

Not sure which treatment is right for you?

Book a consultation with Dr. Samhitha Reddy and get a personalised treatment plan.

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