What Is A Complicated Excision Of A Pilonidal Cyst?

A pilonidal cyst often starts as an innocuous growth at the rear side of the body between the cleft of the buttocks. It begins in a hair follicle and gradually grows to contain hair and skin debris. Things appear quite manageable till now. However, complications arise when the pilonidal cyst gets infected. As it triggers a range of symptoms and gets extremely painful, pilonidal cyst excision becomes necessary. Let’s go through the different stages of a pilonidal cyst and find ways of effective management:

Stage 1 – The Formation Of Pilonidal Cyst

The pilonidal cyst is most common in men. It is because of their hairy skin. In addition, prolonged sitting hours, wearing tight clothes, improper hygiene, and being naturally predisposed to the condition are some factors that increase the risk of developing a pilonidal cyst.

It usually starts as a pimple-like growth at the end of the tailbone. It is often discovered accidentally upon touch and hardly interferes with day-to-day activities. Home remedies like Sitz bath and warm compress can help pop open the cyst. A few precautions after that can help you get over the pilonidal cyst without medical intervention. 

Stage 2 – Infection And Growth

If the cyst gets infected it turns painful. The pus accumulation causes the area to swell up and turn tender to touch. Fever-like symptoms tend to set in and one feels nausea and fatigue. Incision and drainage are the most likely treatments to clear off the pus. Depending upon the overall condition and the severity of the symptoms, the colorectal surgeon may decide to leave the wound open or close it with stitches. The recovery time will depend upon the type of procedure. While it takes almost a month for the incision to heal, the risk of relapse is high. Pilonidal cysts have a high recurrence rate. This might require more than one procedure to obliterate the pilonidal cyst.

Stage 3 – Complicated Pilonidal Cyst

If left untreated, a pilonidal cyst may grow in the surrounding area and infect nearby hair follicles. The condition may also become complicated if the nearby skin tissue gets infected. Such cases of pilonidal cysts require a pilonidal cyst excision surgery. The procedure involves careful excision of the pilonidal cyst through a surgical procedure that involves carefully shaving off the part of the infected area.

Cases Wherein Pilonidal Cyst Surgery Become Mandatory

In some cases, the colorectal surgeon may recommend a surgical cyst removal. The procedure is more invasive as compared to incision and drainage. Additionally, like any other surgical procedure, the healing time is longer with an extensive list of precautions. The factors taken into consideration are:

Size Of The Cyst – If the cyst is big, it will be difficult to drain the pus completely, thus, not being able to provide complete relief.

The Number of Hair Follicles Involved – The pilonidal cyst stars in a hair follicle. However, it can extend to other hair follicles, leading to severe symptoms and pain.

Number And Frequency Of Episodes – For patients who are prone to recurrent pilonidal cysts, the colorectal surgeon may consider a more invasive surgical procedure.

Excision pilonidal cyst techniques like the rhomboid flap technique start with carefully draining and cleaning the cyst cavity. The surgeon takes note of the surrounding diseased skin tissue and carefully removes the entire area. The wound cavity is then packed with healthy skin tissue taken from another body part. The healthy skin is grafted into the wound, leaving no hollow cavity. The entire area is sealed off with stitches and secured with a sterilized bandage.

The success of the rhomboid flap technique largely depends upon the skill and expertise of the surgeon. Proper post-procedure care is important to minimize the risk of infection. Also, periodic follow-up visits after surgery are important to keep track of the healing. But to get over the risk of developing a pilonidal cyst completely, it is important to bring along a change in a range of lifestyle habits. This includes avoiding a sedentary lifestyle, incorporating healthy eating habits, and maintaining proper hygiene. Make sure that the area is regularly waxed to clear off all associated risks.  

Final Thoughts

A pilonidal cyst may have different outcomes. Different people experience and exhibit different types of signs and symptoms. However, experts advise that the cyst must not be taken lightly. Also, leaving the cyst untreated can trigger complications.

As the prognosis of the disease is widely dependent upon the choice of the most appropriate treatment plan with its timely execution, discussing your case with a certified and trained colorectal surgeon is a must. Dr. Allen Kamrava MD MBA is well-established in this field. His careful assessment, and correct diagnosis followed by rolling out the most appropriate treatment plan based on the degree of severity has helped many patients get rid of their pilonidal cysts permanently. Dr Kamrava lays equal stress on post-procedure management to ensure that the risk of pilonidal cyst relapse is minimized. This includes rolling out well-managed follow-up schedules and providing comprehensive post-procedure care. If you or your loved one is looking for expert advice for pilonidal cyst excision and want complete insight into possible treatment outcomes, schedule a consultation with Dr. Kamrava today. 

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