Operation

• Chronic infection of a large pilonidal cyst (sinus pilonidalis)
• Chronic recurrent pilonidal cyst despite attempts at conservative surgical treatment

Surgery is performed under general anesthesia with the patient in the prone position (face down – on the abdomen). The operation consists of removing the cyst, followed by a skin flap.

After resection, the skin flap slides over the cavity so that it is filled and covered. The gluteal fold becomes shallower and less deep and the suture is moved lateral of the midline to decrease the risk of a wound dehiscence and recurrence.

Recurrence after skin flap:

• 6,4 (< 10%)

Wound dehiscence (loosening / falling open):

• 9 – 40%

Dehiscence after a skin flap heal faster than after resection in the buttock cleft of the pilonidal cyst.

Fluid accumulation under the wound (seroma)

Traetment: Spontaneous absorption of the fluid or puncture-aspiration of the fluid.

Normal symptoms

• Pain in the buttock cleft is normal but should subside over time.
• Oozing of wound fluid during the first weeks should decreases with time.
• Postoperatively, it is normal to feel an induration at the level of the cyst upon injection of a biological glue.

Abnormal symptoms

You should contact your surgeon, GP or go to the emergency department:

• If the pain increases over time.
• If the fever does not subside.
• If discharge of purulent fluid.
• increases over time.
• If blood loss increases over time.

If certain symptoms seem abnormal to you contact your doctor.

If this is not possible, you can contact avec your surgeon.

If you are unable to contact your GP or your surgeon, go to the uremergency department at St Elizabeth Hospital in Uccle.

No effect on fecal continence or sexual function after pilonidal cyst treatment.