Pilonidal Cyst Excision

Question 1

What is pilonidal disease?

Answer 1

Chronic gland infection in the depths of the gluteal cleft

Question 2

While the glands and resulting pits can occur anywhere along the gluteal cleft, where do they occur most often?

Answer 2

In the superior gluteal cleft over the sacrum

Question 3

Pathogenesis of pilonidal disease?

Answer 3

Follicles in the midline gluteal cleft get blocked, infected, and then drain leaving open midline pits. In the depths of the cleft, these pits have a vacuum effect on loose hair which is literally sucked into these pits.

Question 4

Epidemiology of pilonidal cysts (gender, age)?

Answer 4

M>F (3:1 ratio)
Between 15-40 with peak incidence around 16-20 years
Rare after age 40

Question 5

Pilonidal disease occurring inferior in the gluteal cleft and close to the anus may be difficult to distinguish from an ___. Pilonidal disease off the midline may mimic ___.

Answer 5

Anal fistula; hidradentitis

Question 6

Because incisions in the midline gluteal cleft heal poorly, an acute abscess should be drained through a ___ incision at least ___ cm off the midline.

Answer 6

lateral; 2

Question 7

Indications for pilonidal cyst excision and marsupialization?

Answer 7

Recurrent acute pilonidal infections

Chronic pilonidal sinus

Question 8

What is the goal of marsupialization?

Answer 8

Minimize the wound size and prevent premature wound closure

Question 9

Post-op care for pilonidal cyst excision and marsupialization?

Answer 9

Wound care with daily showers or sitz baths, cleansing of wound, and removal of all hair within 3-4 cm of wound edges. Packed wet-to-dry with normal saline twice daily

Question 10

4 potential complications of pilonidal cyst excision and marsupialization?

Answer 10

Recurrent pilonidal sinus formation
Infection
Bleeding
Delayed wound healing