[The radical treatment of sacrococcygeal pilonidal cysts]

Sacrococcygeal pilonidal disease may take a variety of forms: a silent chronic form, acute with abscess and a chronic or acute form with fistula. In the acute form surgery consists of the incision and evacuation of the purulent matter, postponing definitive surgery to a second phase, which is not always necessary, considering that in 60% of cases patients do not manifest any further symptoms. The final operation may be performed using a closed, semi-closed and open technique. The authors performed a retrospective review of 64 patients, including 44 males and 20 females. 75% of operations were performed using an open method, 22% with a closed method and 3% with a semi-closed method. Recidivations using the open method amounted to 8% (6% with a single recidivation, 2% with two recidivations), and 14% with the closed method. Average hospital stay was 5.8 days with the open method and 7.3 with the closed method. Patients operated using the open method were discharged after two or three days and dressings were applied using gauze soaked in Betadine solution after cleaning with hydrogen peroxide. The scar was fully formed in around 45 days.