Can Pilonidal Disease Return After Surgery?

Pilonidal disease typically forms near the top of the buttocks, near the tailbone. Pockets of hair and debris get trapped under the skin and cause infection, often chronic. While common in young people, it is also prone to occur in anyone who sits for long periods of time. 

When the area becomes infected, the primary symptom is pain. The region near the crease of the buttocks becomes inflamed and swollen and may leak pus as the infection worsens. Treatment for a pilonidal abscess usually starts with surgical drainage. Excision surgeries may also be done. 

However, pilonidal disease frequently comes back after surgery. As an expert in the treatment of recurrent pilonidal disease, Dr. Lisa Perryman offers patients procedures based on the specialized Bascom cleft lift technique. 

It’s an approach that reshapes the area of the buttock cleft to prevent it from becoming reinfected. Originally developed as a revision after surgery when pilonidal disease recurs, the cleft lift is now used as a first-line procedure, too. 

Pilonidal disease

Pilonidal disease is a chronic condition that frequently affects those with deep buttock clefts. Infections start around an abnormality called a pit, often caused by a hair piercing the skin and providing an entryway for skin debris and bacteria. 

An infection usually forms around one or many of these pits. Simple lancing of an abscess carries a high recurrence rate of about 85%, so lancing alone is only a temporary solution. 

The cleft lift procedure

Formerly, large-scale incisions were common when performing excision surgery on a pilonidal disease. This often left a surgical wound along the line of the buttock cleft, an area that’s hard to keep clean and dry to promote healing. This makes it easy for infection to take hold in the area again. 

One of the goals of cleft lift procedures is to bring the incision and suture line out of the buttock cleft and reshape the area to prevent new pits from forming and leading to future recurrent pilonidal disease.

 This is accomplished with an incision to the side of the cleft. After that, Dr. Perryman moves skin and subcutaneous fat to make the cleft more shallow, with an off-center suture line that’s better placed for trouble-free healing. 

The cleft lift is usually performed as outpatient surgery. Typically, you’ll return to school or work two weeks after a cleft lift procedure and be fully healed in about four weeks. 

The National Institute of Health (NIH) reports that cleft lift procedures have an overall success rate of 96.6% and that all categories of patients with pilonidal disease benefit from this approach. 

Every patient’s situation is unique, so the best way to learn more about your condition is to consult with Dr. Perryman. Contact our office in Parker, Colorado, today and book your appointment by phone or online.