Definition & Overview
Pilonidal cyst excision is the process of surgically removing a pocket of tissue that abnormally grew around a hair follicle. The cyst is typically located near the tailbone, at the top of the buttocks crease.
A pilonidal cyst contains both hair and skin debris that accumulates after the hair punctures and embeds itself in the skin. When hair burrows back into the skin, inflammation occurs as the body identifies it as a foreign body that needs to be attacked. Over time, cyst forms around the base of the hair, resembling that of a small pit or pore in the skin with a dark spot in the centre.
Who Should Undergo and Expected Results
Patients with pilonidal cyst may undergo this procedure, particularly if:
- It is a recurring condition
- If the abnormal growth is causing severe discomfort and impacts the patient’s daily activities
- It causes the formation of sinus tract or a small abnormal channel
However, this procedure is usually deferred if there is an active infection and if pus has already formed. This condition, termed pilonidal disease, has to be resolved first by opening the cyst to drain the pus and other fluids. Once the infection is cleared through antibiotic therapy, the patient can go ahead and undergo pilonidal cyst excision.
The procedure has a high success rate, though it may take several weeks for the wound to heal. The patient is usually allowed to go home immediately but would be advised to rest for several days. Care should be taken not to put any stress on the wound and strenuous activities are usually avoided for several weeks.
How is the Procedure Performed?
For the procedure, the patient is administered with anaesthesia before the hair is shaved off or clipped from the affected area. The nasal cleft is then exposed and the sinus tracts identified and probed using a lacrimal duct probe. In a simple pilonidal cyst excision, electrocautery is used to remove the tissue growth and seal the wound at the same time.
For more complex excision techniques, the surgeon typically removes the cyst and designs a flap from the surrounding skin to cover the wound. This promotes healing by keeping the wound away from the midline. Examples of these techniques include the Karydakis flap, the Limberg flap, the Z-plasty, and the Bascom procedure.
In rare cases wherein the primary pilonidal cyst excision failed and had led to the recurrence of the condition, the more complicated myofasciocutaneous gluteal flap is performed. This involves the isolation of some parts of the gluteal muscles and its blood vessel. The flap is then rotated into the wound once the recurrent cyst has been removed. The procedure is highly specialised and is performed as the last resort for removing the cyst.
In removing a small cyst, the surgeon may use sutures to close the wound. However, bigger cysts may require open wound technique where sterile gauze is used as cover while the wound heals. The dressing has to be replaced regularly to prevent bacterial infection and promote healing.
Possible Risks and Complications
Pilonidal cyst resection carries the risks of:
- Adverse reaction to anaesthesia
- Wound infection
- Delayed healing of the wound
- Wound dehiscence, in which the wound ruptures along the incision line
Steele SR, Perry WB, Mills S, Buie WD, Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the management of pilonidal disease. Dis Colon Rectum. 2013 Sep. 56 (9):1021-7.
McCallum IJ, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ. 2008 Apr 19. 336(7649):868-71
What is Pilonidal Cyst Excision: Overview, Benefits, and Expected Results
A pilonidal cyst is a painful condition that occurs in the crease between the buttocks and can cause significant discomfort and inconvenience. When conservative treatments fail to provide relief, pilonidal cyst excision becomes a viable option. This article provides an overview of what pilonidal cyst excision entails, its benefits, and the expected results for patients.
Understanding Pilonidal Cysts
Pilonidal cysts are cystic masses that form in the sacrococcygeal area, commonly known as the tailbone region. These cysts typically contain hair, debris, and sometimes, infection. They are often associated with friction and pressure in the buttocks area, which occurs due to factors such as prolonged sitting, sweating, and poor hygiene.
Pilonidal cysts can cause symptoms ranging from mild discomfort to severe pain. Some common signs and symptoms of pilonidal cysts include:
- Tenderness or swelling in the tailbone area
- Redness and inflammation
- Drainage of pus or blood
- Foul-smelling discharge
- Fever, in cases of infection
- Difficulty sitting or moving
Pilonidal Cyst Excision Procedure
Pilonidal cyst excision is a surgical procedure performed to remove the cyst and any surrounding infected tissue. The procedure is performed under either local or general anesthesia, depending on the patient’s preference and the surgeon’s recommendation.
During the surgery, the surgeon makes an incision to access the cyst and surrounding tissue. The cyst is then carefully dissected, removed, and any hair or debris within the cyst is cleared. In cases where there is infection, the infected tissue is also excised. Once the cyst and infected tissue are removed, the incision is closed using sutures or stitches.
Benefits of Pilonidal Cyst Excision
Pilonidal cyst excision offers several benefits for individuals suffering from pilonidal cysts:
- Permanent removal: Pilonidal cyst excision removes the cyst and any potential sources of recurrence, providing a long-term solution.
- Pain relief: The surgery alleviates the pain associated with the cyst and allows patients to resume normal activities without discomfort.
- Improved quality of life: Patients often experience improved quality of life after the surgery, as they can sit, move, and engage in physical activities without limitations.
- Prevention of complications: Removing the cyst reduces the risk of complications, such as infection or the development of abscesses.
Expected Results and Recovery
The expected results and recovery after pilonidal cyst excision vary from person to person. However, most patients can expect the following:
- Relief from symptoms: Patients typically experience immediate relief from pain and discomfort after surgery.
- Improved wound healing: The incision site will gradually heal over time, and proper wound care instructions should be followed to facilitate healing.
- Ability to resume activities: Patients can usually resume normal activities, including sitting and exercising, within a few weeks after surgery.
- Lower chance of recurrence: Pilonidal cyst excision significantly reduces the chances of the cyst returning.
It is essential to follow the surgeon’s post-operative instructions diligently to ensure a smooth recovery. This may include keeping the wound clean, changing dressings regularly, and avoiding strenuous activities until fully healed.
Pilonidal cyst excision is an effective surgical procedure that offers long-term relief for individuals suffering from pilonidal cysts. By removing the cyst and any affected tissue, patients can experience immediate pain relief and improved quality of life. The expected results of the procedure are generally positive, with a lower chance of recurrence. If you are experiencing symptoms of a pilonidal cyst, consult with a qualified healthcare professional to explore the possibility of pilonidal cyst excision.