Pilonidal cyst removal surgery is a popular treatment protocol. It helps get rid of the painful growth at the end of the tailbone. It involves removing the affected and infected area. For this several surgical options are available. But the condition has a very high relapse or recurrence rate. Therefore, a lot goes into deciding the type of surgery to manage the condition effectively.
Understanding Pilonidal Cyst Removal Surgery
Surgery is the last resort in pilonidal cyst treatment. In fact, surgical intervention is often mandatory for long-term relief. Some surgeries are topical and aim at clearing off the surface. But for more complex cysts, a comprehensive and invasive procedure is required that deeply removes the affected area. The patient invariably has many questions in mind that are related to the cure and prognosis of the condition.
Available Options For Pilonidal Cyst Surgery
A colorectal surgeon is a specialist surgeon for the job. For mild cysts with mild symptoms, a pilonidal cyst antibiotic treatment strategy is followed. Monitored and guided intake of antibiotics will remove the pus for the cyst. As the wound dries, recovery is quick.
But for hard-to-treat pilonidal cysts, antibiotics alone may not suffice. Complex and chronic cases require a collaborative approach. It involves surgical removal of the affected skin tissue followed by antibiotics to spur healing and recovery.
Incision and Drainage
This is a basic approach to treat pilonidal cyst. A small cut is made to cut open the cyst. The accumulated pus, fluid, hair root, and skin debris are drained out. If the required cut is small, the procedure is performed without anesthesia. However, for bigger cysts, doctors prefer performing it under local anesthesia. The procedure provides immediate relief and recovery is quick. However; as the recurrence rate of pilonidal cysts is very high, it is often seen as a transitional therapy for acute infections.
Excision
This is a more comprehensive surgery. It aims at complete removal of the cyst and the surrounding tissue that appears infected. The doctor will cut open the cyst and excise the infected tissue along with the sinus tracts. The procedure is typically an open procedure. However, with medical advancements, doctors now perform it with minimally invasive techniques. You must have heard about endoscopy and laparoscopy! Based on the extent of removal, the wound may be left open or sealed with sutures.
Open wound excision and close wound excision are therefore the two available options. The recovery time in a close wound surgery is almost 4 weeks. For open wound surgery, it may run into several months. The choice of surgery is case-specific and depends upon tackling individual symptoms.
Rhomboid Flap Surgery
This is the most invasive and comprehensive surgical approach. It is typically suggested for patients with chronic cysts. The flap procedure will require removing a part of a healthy skin from an adjacent area. This skin patch is grafted into the wound cavity after incision and excision of the cyst. The opening of the wound is then sealed with sutures. As the wound cavity is filled with a healthy skin patch, it leaves no room for skin debris to accumulate again. This lowers the risk of recurrence considerably. Healing happens over several months.
Which Procedure Is Best?
The surgery for pilonidal cysts offers several benefits. There is an instant relief from painful and challenging symptoms. This improves the quality of life. By removing the cyst and affected surrounding skin tissue, there is a significant reduction in the risk of recurrence. But the choice of procedure will depend upon understanding the risks and complications of each.
Also, it is important to ensure complete and permanent recovery. For this several factors are taken into consideration.
Type of Surgery – The incision and drainage is the most basic treatment plan. It is best for acute cases as it provides immediate relief. But the risk of recurrence is highest. If you fall in the high-risk category, it’s best to go in for close wound surgery or the more comprehensive rhomboid flap surgery.
Wound Care – Take proper note of the wound care instructions. Failure to adhere to the guidelines may push you towards a higher risk of relapse. So maintain proper hygiene and follow the post-operative guidelines to ensure faster healing and quick recovery.
Lifestyle Changes – A healthy body has an inbuilt defense mechanism in place. Proper weight management, diet control, healthy eating habits and active exercise routine puts you in better space. On the contrary, habits like smoking and drinking make the body weak and more prone to developing the awkward condition.
Hair Free – One of the key ways to minimize the risk of developing pilonidal cyst is to keep the area hair-free. Methods like waxing and shaving are effective. For permanent hair removal, one may consider laser hair removal techniques.
Hygiene – Do not compromise on hygiene at any cost. Failure to maintain proper hygiene increases the risk of developing the condition. During the postoperative phase, it is important to help keep the risk of recurrence low.
Final Thoughts
As discussed above, the choice of procedure will depend upon several factors. Of these, the complexity of the cyst, the severity of the symptoms, and the history of recurrence are aspects that are given prime importance. An expert colorectal surgeon like Dr. Allen Kamrava MD MBA closely inspects every case to roll out a customized treatment plan. Due consideration is given to patient preference and cost attributes.
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