Pilonidal disease forms in hair follicles in the crease between the buttocks, typically near the tailbone. Favoring individuals in early adulthood, more often than not it can become chronic.
Complicated cases often require surgery, and while a variety of approaches are available, Dr. Lisa A. Perryman of Colorado Colon & Rectal Specialists in Parker, Colorado, recommends the Bascom cleft lift procedure. This surgery not only clears away the symptomatic disease, but it also reshapes the surrounding area, dramatically reducing the chance of recurrence.
This month, we explore surgical treatment alternatives for pilonidal cysts, so you can make an informed decision about your own care.
Pilonidal cysts can be painful and inconvenient. They can make sitting uncomfortable, and the leaking blood and pus drainage can soil your clothing. Infections can frequently return and can become serious.
Usually, the severity of the disease—including the rate of recurrence—suggests one of several courses of treatment. Your body and lifestyle may also influence treatment, with considerations like your ability to heal and cosmetic concerns in terms of scars forming.
Each surgery option has its pros and cons. We’re here to review and discuss those with you.
The primary goal of every pilonidal surgery is to remove the disease altogether. The differences among procedures come down to management of the surgical wound.
With the simplest approach, the diseased tissue is removed, and the wound is stitched shut. This may be suitable for smaller, less complex cases, but the recurrence rate is high.
With more complex situations, the surgical wound is left open for natural healing. You may need gauze packing or dressing, depending on the depth of the wound. This surgery is, unfortunately, associated with discomfort during the healing process and a high recurrence rate.
With this surgery, the midline pits that appear on the surface of the skin are removed and stitched closed, and the underlying sinus cavity is debrided. Debridement removes the damaged or infected tissue to improve the healing potential of the remaining healthy tissue.
A problem with conventional pilonidal surgeries is that, once healed, the problem remains in the buttock crease, a region that traps humidity, slows healing, and leads to recurrence.
Pilonidal cleft lift surgery, also known as the Bascom procedure, reshapes the area to make the buttock crease more shallow. At the same time, the surgical incision is pulled to one side, out of the cleft, allowing for better wound management and healing.
The National Institute of Health (NIH) reports the cleft lift surgery has a 96.6% success rate. Dr. Perryman specializes in the advanced cleft lift procedure because of the very low rate of recurrence when compared with other techniques.
If you’re suffering from pilonidal disease—whether it’s your first episode or a more chronic condition—call or message Colorado Colon & Rectal Specialists for the best care.
