Pilonidal Cyst Archives

Pilonidal, research on failed surgery and cleft lift procedure MUST READ

Failed Pilonidal Surgery

New Paradigam and New Operation Leading to Cures

by John Bascom, MD, PhD; Thomas Bascom, MD

I will type this as is it's important and is a little longe but very important. If you want to see the site it's

www.archsurg.ama-ssn.org/issures/current/abs/soal1197.html

Hypothesis: Refractory pilonidal desease is due to damage of the epidermis in the deep gluteal cleft by moisture and bacteria, rather than to damage in deep tissues. A new paradigm suggests that a procedure to change the shape of the gluteal cleft will improve results.

Design: Before and after trial.

Setting: Community provate practice with extensive experiance in pilonidal disease, providing ambulatory and hospital care.

Patients: 31 with severe refractory pilonidal disease, with a median follow-up of 20 months in 27 patients (87%). Patients had undergone a total of 141 operations with wounds still open for a combined total of 252 years

Intervention: The deep gluteal cleft was reshaped with a skin flap. Deep tissue was left essentially intact.

Main Outcome Measures: Number healed, time to healing, number of operations required.

Results: Wounds in all 31 patients healed, 28 after a single procedure. The time to healing was rapid, within one week in 22 patients. There were no recurrances.

Conclusions: For refractory pilonidal disease, the cleft lift procedure produced rapid results by drawing intact skin over the cleft and bringing the suture line out to open air. The failures of old mthods and success of this new one suggest a need for a paradigm shift in our understanding of pilonidal disease. The source of disease is not the deep tissue but rather the epidermis in the moist, hypoxic, and bacteria-laden gluteal cleft. This also has implications for initial treatment of pilonidal disease, where simple, nonoperative treatments are often effective.

Sorry for any type-o's I was just wanting to post this information. It gives a better idea on how we get this Pilonidal problem and avoid many surgeries. How we can try and fight recurrances with cleaning properly, shaving the area. However there is another study I've read that also gives an idea on how pilonidal suffers may have a weaker immune system in their skin and thus not be able to fight minor skin infections very well and could lead to a Pilonidal problem. I'll try and get that research information together it's very interesting.

But this does give hope for repeated recurrances and problems.

just another suffer

Pilonidal, research on failed surgery and cleft lift procedure: Archive