✦ RHOMBOID FLAP REPAIR

Limberg Flap (Rhomboid flap)

Q: When is Limberg flap recommended?

Limberg flap is preferred for extensive primary disease, recurrent sinuses, or large defects where simple closure is not feasible. The decision depends on size of disease, anatomy and previous surgeries.

Q: Will the flap leave a large scar?

There is a rhomboid-shaped scar that fades significantly over months. Most patients consider it acceptable in exchange for durable healing and low recurrence.

Q: How long does it take to heal?

Primary wound healing is usually complete in 3–4 weeks. Most patients return to office work in 1–2 weeks and resume gym or heavy activity after 4–6 weeks.

Q: Will my pilonidal sinus come back after Limberg flap?

Recurrence rates are low (under 10%) when the technique is well-performed and combined with good post-operative care, hair removal and hygiene.

Rhomboid-shaped excision and rotational flap closure — fills the defect with healthy tissue, flattens the natal cleft, and gives durable, low-recurrence results for pilonidal sinus.

75–105 min PROCEDURE

1–2 Days HOSPITAL STAY

>90% SUCCESS RATE

1–2 Weeks RETURN TO WORK

What is Limberg Flap (Rhomboid flap)?

The Limberg Flap, also called the Rhomboid flap, is a well-established surgical technique for pilonidal sinus disease, particularly effective for larger or recurrent cases. The diseased tissue is excised in a rhomboid (diamond) shape, and a matching rhomboid flap of healthy tissue is rotated from the adjacent buttock to fill the defect with healthy, well-vascularised tissue. The flap also flattens the natal cleft, reducing recurrence. Dr. Tejasree Vengala, an experienced female proctologist in Hyderabad, performs Limberg flap surgery at Lux Hospitals, Hyderabad, with attention to clean technique and durable, off-midline healing.

Suitable for patients with extensive primary pilonidal disease, recurrent pilonidal sinus after previous surgery, or large defects where flap reconstruction gives the best chance of complete healing.

How the Procedure Works

Anaesthesia & Marking

Surgery is performed under spinal or general anaesthesia. A rhomboid pattern is marked over the diseased area.

Rhomboid Excision

The sinus and surrounding unhealthy tissue are excised in a rhomboid shape down to the underlying fascia, ensuring clean margins.

Flap Design & Mobilisation

A matching rhomboid flap of healthy skin and fat is designed from the adjacent buttock and gently mobilised with its blood supply preserved.

Flap Rotation & Inset

The flap is rotated into the defect and sutured in layers, filling the area with well-vascularised tissue and flattening the natal cleft.

Drain & Recovery

A small drain is placed and removed when output is minimal. Most patients are discharged in 1–2 days with structured wound care and follow-up.

Outcomes

75–105 minDURATION

1–2 DaysHOSPITAL STAY

>90%SUCCESS RATE

3–4 WeeksFULL HEALING

Who Needs This Treatment?

→Effective for large or recurrent pilonidal disease
→Brings healthy, well-vascularised tissue to the defect
→Off-midline closure with low recurrence rate
→Single-stage procedure with primary healing
→Faster return to work compared to open healing techniques
→Excellent durability for long-term cure

When the disease is extensive or recurrent, a Limberg flap turns a difficult problem into a clean, healed wound. We move healthy tissue into the defect, flatten the cleft, and give the body the best possible chance to heal once and for all.

— — Dr. Tejasree Vengala, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

When is Limberg flap recommended?+

Will the flap leave a large scar?+

How long does it take to heal?+

Will my pilonidal sinus come back after Limberg flap?+

Not sure which treatment is right for you?

Book a consultation with Dr. Tejasree Vengala and get a personalised treatment plan.

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