Depending on the stage and the clinical feature in which it presents, pilonidal cysts can be treated in so many different ways ranging from the use of broad-spectrum antibiotics for conservative treatment to shaving of hair around the cyst area to incision, drainage and eventual curettage or excision of the cyst.
Even though there are many surgical options in the management of Pilonidal cysts, this depends on the staging or presence of recurrence. They all have similar purposes and goals which is to offer the best comfort to the patient either before or after the surgery, with short hospital stay and good wound healing. Also to ensure no complications and little or no risk of recurrence or morbidity as well as allow the patient to resume his/her daily activities as soon as possible and get back to work.
Acute Pilonidal Cyst Surgery
For an acute case of Pilonidal cyst, incision, drainage, and curettage is usually utilized in its management. This is often a simple procedure that can be carried out inside the office whereby the doctor numbs the area with a local anesthetic agent and then the doctor cuts into the cyst especially laterally away from the midline. Then he drains out the content, after which the wound would be packed with sterile gauze or closed with stitches.
The option to be adopted usually is determined by the location of the cyst. For cysts at the intergluteal clefts, they typically heal poorly after the surgery; this is due to the constant friction between the region and the adjacent cloths worn and also the central position on the body as it is being subjected to continuous traction during sitting.
So particular importance should be put to wound dressing and treatment, so to facilitate proper wound healing.
Chronic Pilonidal Cyst Surgery
When the cyst keeps coming back with lots of recurrences after series of Incision and drainage, the doctor usually opts for excision of the cyst rather than continuous incision and drainage.
The procedure can include excision and leaving the wound open to heal by secondary intention. This ensures adequate drainage of the wound and avoid infections that can result from stitching the wound area back after the Incision, called primary closure.
The disadvantages of this procedure may, however, involve constant wound dressing to reduce the risk of getting infected
Other procedures that can be done could include Incision and marsupialization, Bascom procedure, or asymmetrical incisions.
Recovery from the Surgery
Just like any form of surgery, the patient has to be monitored and kept stable by keeping to the general advice and instructions given to them after the surgery. This would ensure great wound healing with no prolonged wound healing or dressing or abnormal wound discharge.
These instructions range from keeping the surgical wound area clean always by the frequent and regular dressing of the site, checking for any sign of wound infection or inflammation. Also, checking for swelling, pain, redness, or discharge.
Patients are also advised to keep to the next appointment date so doctors can monitor the progress of the healing to avoid wound breakdown, in some cases, the doctors may also offer to shave the growing hair from the site of surgery to prevent any recurrence.
Generally, the prognosis and outlook of a patient that undergoes pilonidal cyst surgery are usually great and excellent with complete cure very possible.