Excision of Pilonidal Cyst or Sinus; Complicated

Name of the Procedure:

• Common Name: Excision of Pilonidal Cyst
• Medical Term: Pilonidal Cystectomy

Summary

Excision of a pilonidal cyst is a surgical procedure to remove a cyst or sinus located near or on the natal cleft of the buttocks. The term "complicated" refers to cases where the cyst has become infected, larger, or includes significant sinus tracts.

Purpose

This procedure aims to treat infected or recurrent pilonidal cysts, alleviate pain, and prevent further infections. Removing the cyst helps to reduce the risk of future complications and improves patient quality of life.

Indications

• Recurrent infections of the pilonidal cyst
• Presence of an abscess or multiple sinus tracts
• Persistent pain or drainage from the cyst area
• Failure of non-surgical treatments

Preparation

• Patients may be advised to fast for a certain period before the surgery.
• Medications, especially anticoagulants, might need to be adjusted.
• Preoperative assessments may include blood tests or imaging studies.

Procedure Description

1. Anesthesia: The patient is given local or general anesthesia.
2. Incision: An incision is made over the cyst or sinus.
3. Excision: The cyst and surrounding sinus tracts are carefully removed.
4. Closure: Depending on the extent, the wound may be left open to heal by secondary intention or partially closed with sutures.
5. Dressings: Sterile dressings are applied to the surgical site.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity.

Setting

This surgery is usually performed in a hospital or outpatient surgical center.

Personnel

• Surgeon (specializing in general surgery)
• Anesthesiologist or nurse anesthetist
• Surgical nurses and assistants

Risks and Complications

• Infection
• Bleeding
• Scarring
• Recurrence of the cyst
• Wound healing issues
• Anesthesia-related risks

Benefits

• Relief from pain and discomfort
• Reduced risk of recurrent infections
• Improved quality of life
• Most patients experience immediate relief once the surgical site heals

Recovery

• Post-operative care includes keeping the wound clean and dry.
• Pain management typically involves over-the-counter pain relievers or prescribed medication.
• Patients are usually advised to avoid strenuous activities for a few weeks.
• Follow-up appointments are necessary to monitor healing.

Alternatives

• Non-surgical options like antibiotics for minor infections.
• Less invasive procedures like incision and drainage.
• Pros and Cons: Non-surgical treatments have a higher recurrence rate; therefore, surgical excision is often considered more definitive.

Patient Experience

• During the procedure, patients will be under anesthesia and should feel no pain.
• Post-operatively, mild discomfort or pain can be expected.
• Pain is managed with medications, and detailed aftercare instructions are provided to ensure comfort and proper healing.