At the rear of the body sits a pilonidal cyst. It starts toward the end of the tailbone. What it appears like is a pimple-like development between the buttocks’ clefts. But it hurts, particularly if it is pus-filled and chronic. Pilonidal cyst treatment approaches begin with conservative therapy that calls for pit-picking the lesion and antibiotic administration. However, pilonidal cyst removal surgery is highly advised for more complicated and severe cases.
Types Of Pilonidal Cyst Removal Surgery
There are various surgical techniques available. But the treatment for pilonidal cyst will depend upon the severity of the condition and the range of symptoms. Surgeon’s experience is most important when performing complex cyst removal surgeries. The role of professional follow-up is extremely important to reduce the risk of recurrence and cyst relapse.
Incision and Drainage
This is the most basic treatment pilonidal cyst. It is also the least invasive. Simply by cutting open the cyst, the surgeon will allow the pus and accumulated debris to flow out. The cyst cavity is thoroughly cleaned and sterilized. Relief from symptoms is immediate and recovery takes a couple of days.
Excision
Although incision and drainage is the least demanding procedure, it is linked to a high recurrence rate. Surgeons therefore use it as a prelude for a more extensive surgery. The excision procedure is for more complex and recurrent cysts. It has two approaches open wound surgery or close wound surgery.
During surgery the surgeon will remove the entire pilonidal cyst along with the surrounding affected tissue. Then the wound is flushed nicely. The depth of the excision will determine whether the surgeon leaves the wound open or closed with stitches.
Although open wound surgery takes more time to heal, its recurrence rate is lower. Also post-operative care is very important to reduce the risk of secondary infection. On the other hand, close wound surgery allows faster healing as the opening of the wound is stitched together. But the risk of cyst relapse is high. Carefully follow the post-operative guidelines for prolonged sitting and strenuous activities as it can break the sutures and cause the wound to open again.
Rhomboid Flap Surgery
It is the most elaborate procedure. It is advised only for very complex and chronic cysts. It is extensively invasive and requires a high level of professional skill for flawless execution. The procedure involves removing the cyst through excision. Subsequently, a part of healthy skin (taken from another site) is grafted in the wound cavity. The wound is stitched with sutures. As there is no hollow space in the wound cavity, risk of cyst relapse is minimal. But healing happens slowly and spreads over several months. Post-procedure care and follow-up are extremely important.
Conclusion
The choice of surgical technique for a pilonidal cyst treatment will depend on various factors. Dr. Allen Kamrava MD MBA, an expert colorectal surgeon evaluates each aspect of the case and understands the patient’s preference before suggesting the most appropriate way forward. His years of experience and skill in performing the procedures are an added advantage for the ones seeking long-term relief from the painful and challenging condition.
