Indications for Surgical Treatment

The decision to operate on those with pilonidal disease depends on the state of the affected area. If there is an acute infection, the first step will be to address the infection with antibiotics as well as a first stage drainage. As the infection clears, a more definitive treatment will be pursued. In order to properly treat the pilonidal disease a wide excision may be necessary to remove the disease bearing tissue followed by reconstruction using plastic surgery reconstructive techniques.

Surgical Techniques
  • Incision and drainage
  • Incision and drainage with removal of overlying skin, allowing to heal in with time (healing by secondary intention)
  • Wide excision of diseased tissue and allowing healing with time (healing by secondary intent)
  • Wide excision of diseased tissue and Reconstruction
    • Reconstruction with flap closure – bilateral buttock flap with midline closure – optimizes cosmetic results with more natural appearance and location of scar
    • Rhomboid flap closure
    • Other flap reconstruction

In our experience there have never been recurrence of the cyst. Dr. Som uses a special technique to mark the entire cyst sinus tract to ensure complete resection. Therefore, minimizing recurrence.

Som Kohanzadeh, MD, FACS

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