2025/11/21 by Nida Khan, Khan, Nida
Medicine · #Anorectal Disease Treatments and Outcomes #Hidradenitis Suppurativa and Treatments #Diverticular Disease and Complications
paper · doi:10.17605/osf.io/3zvtr
Title: Excision with Primary Closure vs Limberg Flap for Pilonidal Sinus Disease: A Systematic Review and Meta-Analysis of Randomised Controlled Trials Registration Type: Systematic Review / Meta-analysis Authors: Nida Khan (Corresponding) Shantanu Chandrashekhar Premjithlal Bhaskaran Christi Swaminathan Background / Rationale: Pilonidal sinus disease (PSD) is a common condition affecting young adults, often requiring surgical intervention. Excision with primary closure (PC) and Limberg flap reconstruction (LF) are widely used techniques, but the optimal operative strategy remains debated. This meta-analysis synthesises evidence from randomised controlled trials (RCTs) comparing PC and LF across key perioperative outcomes. Objectives: To compare operative time, hospital stay, pain, wound infection, wound dehiscence, and recurrence between LF and PC using data from RCTs. Eligibility Criteria: Inclusion: – RCTs – Patients with primary or recurrent PSD – Interventions: LF vs PC – At least one outcome of interest – English full text Exclusion: – Non-randomised studies – Case reports/series, reviews – Studies without extractable data Information Sources: PubMed, MEDLINE, EMBASE, Cochrane Library, Google Scholar, and reference lists. Search period: inception to July 2025. Data Extraction: Two independent reviewers extracted data on study characteristics, operative variables, and outcomes. Disagreements were resolved by consensus. Risk of Bias Assessment: Jadad scale, Chalmers criteria, Rangel scale. Outcomes: Primary: Recurrence, wound infection Secondary: Operative time, hospital stay, pain, wound dehiscence Data Synthesis: Using RevMan 5.4 – OR for dichotomous outcomes – MD for continuous outcomes – Random or fixed effects based on heterogeneity – Heterogeneity via Chi² and I² – Significance at p<0.05 Registration Notes: This review is registered retrospectively because data extraction and analysis were completed prior to registration. The review follows PRISMA 2020 guidelines. All data and materials are available on request. Dissemination: Results will be submitted to Annals of Medicine & Surgery