A Pilonidal cyst (pilonidal sinus) is an unnatural growth of skin that commonly occurs near the tailbone or at the tailbone. Because of its location, the cyst usually becomes a chronic condition leading to an infection called a boil or pilonidal abscess. This abscess is filled with dirty smelling pus. So when a pilonidal cyst becomes infected, it can cause severe pain. The infection can further spread from the cyst into the sinus tract causing it to recur and become severely painful. So, the best thing is to find suitable treatment as early as possible. And if less invasive or conservative treatment does not help in eliminating the infection, then pilonidal cyst excision surgery is the option.
Symptoms of pilonidal sinus
Before we move to pilonidal cyst excision surgery, let’s first know the symptoms of pilonidal sinus. So, the symptoms can include the followings:
- Severe pain around the tailbone
- Swelling in the infected area
- Dirty-smelling drainage
- Tenderness in the lower back
Pilonidal cysts occur more commonly in men between puberty and the age of 40. However, women can also get a pilonidal cyst.
So, the followings are the risk factors:
- Heavy, thick, and wiry hair on the lower back
- Sitting for hours
- Friction such as tight clothes or belt rubbing against the skin
- Being overweight
Incision and drainage procedure
Typically, the surgeon will use both incision and drainage to drain the pus from the infected pilonidal abscess. As the name incision suggests, this procedure requires a small cut in the cyst to drain the pus and other material inside it. However, this procedure is not curative. Most pilonidal abscesses get clear completely after the incision and drainage procedure. But those that reoccur often need a more invasive surgical procedure to prevent chronic problems.
When is pilonidal cyst excision surgery necessary?
The doctor may recommend pilonidal cyst excision surgery when:
- Other treatments do not work in clearing the infection from a pilonidal cyst
- The infection reoccurs several times
- The infection become chronic that it needs immediate treatment
During a pilonidal cyst excision surgical procedure, the surgeon drains the pus to remove the entire cyst. The goal of this procedure is to get rid of all the infections and also to prevent abscesses from developing in the future. Moreover, this excision surgical procedure is usually an outpatient procedure.
Excision surgical procedure
The pilonidal cyst excision surgery involves two procedures. First, an incision is made in the abscess, to:
- Completely drain the pus from the cyst
- Removal of the entire area around the cyst
- To prevent further infection, using special antibacterial treatments the wound is cleaned
After the process of excision and cleaning, the surgeon has two options i.e. leaving the wound open or closing the wound with stitches. However, most surgeons prefer to leave the wound open and pack it with sterile gauze and other dressings. This method allows the area to heal from the inside out and also reduces the chances of reoccurrence. However, might take longer to heal completely. Moreover, you will need to change the dressing daily to keep it clean and dry until it is healed.