Pilonidal cyst surgery

Pilonidal cyst Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Surgery

Often the cyst is lanced, and surgery is a method that has met with some success for curing pilonidal cysts. Surgery on a cyst in the natal cleft may involve cutting out the skin and sinus in this area (excision), ormarsupialization. If the wound is packed, the patient or someone close to the patient is trained to replace the gauze packings. They must be replaced daily for 4 to 8 weeks (but healing, and therefore bandage changes, can last up to 1 year). The condition can recur, even after surgery. The chance of recurrence is much greater if the wound is sutured in the midline, compared to excellent results if the resultant scar is away from the midline, thus obliterating the natal cleft and therefore removing the focus of shearing stresses. Some people develop a chronic non-healing pilonidal sinus which must be treated with surgical excision. Rarely do the complications of a pilonidal cyst result in death, however, due to the possibilities of infection from the abscess, the results of an overly untreated case may prove fatal. In recurring or non-healing cases, a Z-plasty may be used to reduce shearing stress on the resulting scar. The end result of the procedure is that the buttocks are effectively merged after the cyst is excised, preventing a relapse.