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Pilonidal disease
1Ferguson-Blodgett Digestive Disease Institute, Grand Rapids, Michigan.
Abstract:
It is the author's preference and recommendation that an acutely infected pilonidal abscess be urgently drained with a simple incision and drainage procedure that is not necessarily viewed as definitive treatment. The patient should be so instructed. The definitive treatment of chronic pilonidal disease can be accomplished in a variety of ways, but our recommendation is excision of all infected tissue and sinus tracts through an elliptical incision with either marsupialization of the wound or beveling of the skin edges. Both marsupialization and beveling serve to minimize the chance of premature skin closure and promote complete healing of the site from the inside out. Weekly postoperative follow-up is strongly encouraged to assess progress and promote proper wound healing.
Insights
Urgent drainage is recommended for acute pilonidal abscesses, with definitive treatment involving excision of infected tissue and sinus tracts for chronic cases. This approach promotes healing from within, minimizing premature skin closure.
Area of Science:
- Surgical Procedures
- Wound Healing
- Proctology
Background:
- Pilonidal abscesses require prompt management.
- Chronic pilonidal disease necessitates effective treatment strategies.
Purpose of the Study:
- To recommend optimal management for acute pilonidal abscesses.
- To outline a preferred method for definitive treatment of chronic pilonidal disease.
Main Methods:
- Acute abscesses: simple incision and drainage.
- Chronic disease: elliptical excision of infected tissue and sinus tracts.
- Wound closure techniques: marsupialization or beveling of skin edges.
Main Results:
- Simple incision and drainage provides initial relief for acute abscesses.
- Excision with marsupialization or beveling promotes internal healing and prevents premature skin closure.
- Weekly postoperative follow-up aids in assessing progress and ensuring proper wound healing.
Conclusions:
- Urgent drainage is advised for acute pilonidal abscesses.
- Excision with specific wound edge techniques is recommended for definitive treatment of chronic pilonidal disease.
- Postoperative monitoring is crucial for successful outcomes.