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Incision and drainage of pilonidal cyst; simple

CPT4 code

Name of the Procedure:

Incision and drainage of pilonidal cyst; simple (also known as "I&D of pilonidal cyst", "pilonidal abscess drainage")


This procedure involves making an incision to drain the pus and debris from a pilonidal cyst. It's typically a quick and straightforward process to relieve pain and treat infection.


The procedure addresses pilonidal cysts, which are painful, pus-filled cysts located near the tailbone. The goal is to alleviate pain, clear the infection, and prevent recurrence.


  • Persistent pain or tenderness in the tailbone area.
  • Visible swelling or redness.
  • Drainage of pus or blood from the cyst site.
  • Recurrent infections or cysts in the same area.


  • Patients may need to avoid certain medications as advised by their healthcare provider.
  • Pre-procedure instructions often include fasting for a few hours, though this varies.
  • Diagnostic tests may include a physical examination and potentially imaging to assess the cyst.

Procedure Description

  1. The cyst area is cleaned and sterilized.
  2. Local anesthesia is administered to numb the area.
  3. A small incision is made over the cyst to allow drainage of the pus and debris.
  4. The cyst cavity is washed out and may be packed with sterile gauze to aid healing.
  5. The wound is dressed properly to protect from infection.

Tools: Scalpel, drainage instruments, gauze, antiseptic solutions.


Typically, the procedure takes about 15-30 minutes.


The procedure is usually performed in an outpatient clinic or a minor procedure room in a hospital.


  • Surgeon or trained healthcare provider (could be a physician or nurse practitioner)
  • Assisting nurse or medical assistant

Risks and Complications

  • Infection at the incision site
  • Bleeding
  • Pain at the incision site
  • Possibility of cyst recurrence
  • Rarely, allergic reactions to medication or anesthesia


  • Relief from pain and discomfort.
  • Resolution of the infection.
  • Quick, minimally invasive procedure.


  • Keep the area clean and dry as advised.
  • Change dressings as recommended by healthcare provider.
  • Follow-up appointments to monitor healing.
  • Avoid strenuous activities until fully healed, typically within 1-2 weeks.


  • Antibiotic therapy (may be used alongside, but not typically sufficient alone).
  • Surgical excision for recurrent or particularly problematic cysts.
  • Pros and cons: I&D is less invasive with a faster recovery compared to surgical excision but has a higher recurrence rate.

Patient Experience

  • During the procedure, patients will feel the initial anesthesia injection but should not feel pain during the incision.
  • Post-procedure, soreness is common and can be managed with prescribed pain relief.
  • Patients should follow aftercare instructions to ensure proper healing and minimize discomfort.

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