Pilonidal Disease Flashcards
the presence of this bacteria can invade through openings caused by ingrown hairs and cause pilonidal abscesses
staphylococcus aureus
this malfunction is on a spectrum that can range from asymptomatic hair containing cysts and sinuses to large symptomatic abscesses of the sacrococcygeal region that can recur.
pilonidal disease
Where to pilonidal cysts or sinuses occur?
midline in the upper part of the natal cleft overlying the lower sacrum and coccyx
the sinuses of pilonidal cysts are formed by what process?
penetration of the skin by ingrowing hair, which causes a foreign body granuloma reaction.
is pilonidal disease a genetic predisposition or an acquired condition?
acquired condition
pilonidal cysts generally occur before what age?
before 4th decade of life
where do pilonidal cysts always occur?
always located in the midline and does not communicate with the anorectum.
Sx of pilonidal disease
swelling, pain, discharge.
abscess will be tender
area of inflammation in the midline of the gluteal crease, with one or more sinus openings.
may present with an abscess that can no longer drain
When would you consider a CBC with Pilonidal disease?
if the patient demonstrates systemic sx… (fever, chills, etc)
what is the treatment of choice for pilonidal disease?
surgery.
superior gluteal crease abscess is an I and D.
abscess at base of spine is better with a complete excision of the area (6 weeks after infection)
DEFINITIVE treatment is a surgical excision in the operating room.
what do you pack the open wounds following pilonidal abscess removal?
moistened sponge, changed daily, “wet to dry”. sterile iodoform gauze.
Why are antibiotics considered temporizing and palliative as a therapy after removal of pilonidal cyst?
recurrence will be the rule until adequate I and D or excision is accomplished. May use for the treatment of surrounding cellulitis.
suggested antibiotics for pilonidal abscess.
Cephalexin (Keflex)
Doxycycline (in the Tetracycline family)
Are pilonidal cysts a MEDEVAC?
retain for uncomplicated. MEDADVICE if needed. MEDEVAC for complicated.
