[Pilonidal cysts: the state of the art and the authors' personal experiences]

After a historical review of the pathogenesis and several therapies suggested for the treatment of pilonidal cysts the authors report the results of a retrospective study performed in the Department of Surgery during a period of four years, with at least 12 months follow-up. This study involved 53 patients (35 males and 15 females, 23 years average age) affected by pilonidal cyst. These patients were treated for a month with antibiotic therapy and underwent surgery by general anaesthesia. Before surgery blue methylene was injected in the cyst. Between 4 months and 2 years 5.7% of operated patients relapsed. After 10 days antibiotic therapy they underwent surgery again by local anaesthesia and then they followed an open treatment protocol including collagen and silver sulfadiazine, healing by delayed wound closure. Furthermore a depilating cream for the border of the wound was suggested to the patient. These patients healed in a period between 4 weeks and 2 months. No relapses were observed after at least 12 months. In our opinion there is the rationale to suggest an open treatment of relapsed pilonidal cyst based on the use of heterologous lyophilized collagen and silver sulfadiazine: it is well accepted by the patient and effective in relapses.