Pilonidectomy

A pilonidectomy is a surgical procedure used to treat a pilonidal cyst or sinus, which is an abnormal skin growth that usually occurs near the tailbone, at the top of the cleft of the buttocks.

Indications for Pilonidectomy

The primary indication for a pilonidectomy is a symptomatic pilonidal cyst or sinus that has not responded to conservative treatments such as antibiotics, drainage, or other non-surgical methods. Symptoms may include pain, swelling, redness, and discharge.

Types of Pilonidectomy

There are several types of pilonidectomy procedures, including:

• Excision with primary closure: The cyst or sinus is removed, and the wound is closed with sutures.
• Excision with open wound: The cyst or sinus is removed, but the wound is left open to heal on its own. This method may be used for more complex or infected cases.
• Marsupialization: The cyst or sinus is opened and the edges are sutured to the surrounding skin, creating a pouch-like structure that allows the area to drain and heal.
• Laser pilonidectomy: A minimally invasive procedure that uses a laser to remove the cyst or sinus.

Surgical Technique

The surgical technique for a pilonidectomy typically involves:

• Administration of local or general anesthesia, depending on the extent of the procedure and patient preference.
• A small incision is made over the cyst or sinus to access the affected area.
• The cyst or sinus is carefully dissected and removed, taking care to avoid damaging surrounding tissue.
• The wound may be closed with sutures, staples, or left open to heal, depending on the type of procedure chosen.

Postoperative Care

After a pilonidectomy, patients typically require:

• Pain management with medication and rest.
• Wound care, including dressing changes and monitoring for signs of infection.
• Avoiding heavy lifting, bending, or strenuous activities for several weeks.
• A follow-up appointment with the surgeon to remove sutures or staples and assess healing progress.

Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with pilonidectomy, including:

• Infection.
• Bleeding or hematoma.
• Wound dehiscence (re-opening of the wound).
• Recurrence of the pilonidal cyst or sinus.
• Scarring or keloid formation.

Recovery Time

The recovery time for a pilonidectomy can vary depending on the individual and the extent of the procedure. Generally, patients can expect:

• 1-2 weeks of rest and limited activity.
• 2-4 weeks for the wound to heal.
• 6-8 weeks for full recovery and return to normal activities.