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PILONIDAL CYSTS

WHAT IS PILONIDAL DISEASE?

Pilonidal disease (often referred to as a Pilonidal cyst) is a chronic skin and subcutaneous fat infection in the crease of the buttocks typically occurring in teens and young adults. The condition is often the result of hairs that invade the skin in the cleft (crease) and become infected.

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SYMPTOMS:
Most patients with a pilonidal cyst experience large, painful areas that are tender to the touch with openings that have clear, cloudy or bloody discharge. Redness and tenderness with foul smelling pus (discharge), along with possible fever, are indications of an abscess formation.

While pilonidal disease is relatively common, many don’t realize that there is an incredibly high recurrence rate if not treated properly. 

TREATMENT:

The first course of action for patients is typically a round of antibiotics along with draining of the abscess, however, most cases will ultimately need surgery for definitive management. 

Unfortunately, a routine pilonidal cystectomy (midline wound/open) that most surgeons perform has a very high recurrence rate.1 The  cleft lift procedure (Bascom Lift) is another option. 

Dr. Nakhjo is one of a few surgeons in the country who performs the cleft lift procedure. It is an outpatient surgical procedure that is intended to cure pilonidal disease. The procedure takes about an hour  (performed under general anesthesia). Patients are typically home the same day, with minimal discomfort and can return to normal daily activity within 1-2 days and full activity without any restriction in 2 weeks. 

The only procedure proven to succeed in over 95% of cases is the Cleft Lift Procedure (Bascom Lift)
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Cleft Lift Procedure

The cleft lift procedure differs from other procedures in that it only removes scarred skin and minimal underlying tissue, putting the incision sufficiently to the side so it can heal well. Other flap procedures often result in disfiguring scars and fail to sufficiently re-contour the cleft to prevent recurrence.

Benefits of the Cleft Lift Procedure

  • Closed wound, no packing needed

  • Faster return to normal activity (1-2 days)

  • No scarring/disfiguring

  • Minimal pain

  • Lowest recurrence rate among all flap procedures (between 1 and 5%)