Pilonidal Cyst Excision FAQ: What You Should Know

Mild pilonidal infections can sometimes be managed with home care and a course of antibiotics. If that doesn't work, a simple drainage procedure may resolve the pain.

Sometimes, however, more treatment is needed. If the infection recurs, your doctor may suggest performing an excision to remove the affected tissue so that you won't have to deal with repeated flare-ups. In some situations, such as a particularly bad infection, excisions may be performed for first occurrences.

Are All Procedures the Same?

No, there are a wide variety of surgical procedures used in the treatment of pilonidal cysts. You'll need to talk to your doctor about which is best for your needs.

Traditional surgeries involve cutting out the tissue that contains the full sinus tract and the cavity. Other times, only the top portion of the tract and cavity is cut away, while the lower half remains in place. This is known as an unroofing procedure.

In an open procedure, the wound is left unstitched. Closed procedures involve creating a flap of skin and stitching the surgical site closed. Open wounds take longer to heal but may be more successful in the long run.

Another surgical option is pit-picking. This approach removes significantly less tissue because only the cavity is taken out. The incision is much smaller and doesn't require stitches.

Will I Need to Stay Overnight in the Hospital?

Pilonidal cyst surgeries are usually performed on an outpatient basis. You'll be able to go home the same day.

You will need someone to drive you home, however. Undergoing anesthesia can make it unsafe to drive.

How Will I Feel After the Procedure?

Surgery can take a toll on your body. You will probably feel tired and sore afterward. Try to get as much rest as possible.

Sitting up may not be very comfortable. Do it anyway since it can help move fluid buildup away from the surgical site. For comfort, put a donut cushion or a pillow underneath your buttocks. Restrict periods of sitting to no more than 30 minutes at a time.

Keep off of your back while you recover. You'll need to lie on your stomach or your side instead.

You will probably be sent home with a prescription for pain medication. Taking your pills on a regular schedule will help you stay on top of the pain. You may be able to use over-the-counter ibuprofen or acetaminophen as well, but ask your doctor first.

Even with medication, discomfort is to be expected. Applying an ice pack to the site may help. Resting in a shallow sitz bath is another way to find relief, but not all patients are good candidates for this. Check with your doctor before soaking your wound.

How Long Will Recovery Take?

It can take several weeks to feel entirely like yourself again. After a traditional excision, you may need to be off of work for two to four weeks. Open wounds take longer to heal than closed ones.

Recovery for a pit-picking procedure can be easier. In one study, approximately half of the patients were able to go back to work after 24 hours. Most of the people experienced full healing within 3.5 weeks.

Can a Pilonidal Sinus Come Back?

Yes, there's always a chance that you will develop a recurrence of pilonidal disease. No surgical procedure is entirely foolproof, and recurrence can occur after both open and closed surgeries.

Although pit-picking is less invasive, it may lead to a higher rate of recurrence. During the procedure, the doctor cleans out the sinus tract, but some debris may remain. This can lead to reinfection.

You can reduce your chances of a recurrence by practicing good hygiene, staying active, maintaining a healthy weight and regularly removing hair from the area.

Is There a Better Way?

Your pilonidal sinus may be a good candidate for treatment with a minimally invasive laser procedure. In this quick surgery, the pilonidal cyst is cleaned out, and then a small neoV Laser fiber is inserted. The laser's energy seals shut the cavity and the tract. This procedure can be performed on its own or in conjunction with pit picking.

Laser treatment is advantageous because the recovery time is usually shorter and less painful. You may not need as much pain medication, and you may be able to resume normal activity sooner. Plus, some research has shown a recurrence rate of less than 3%.

Now that you know what to expect, you hopefully feel more prepared for your upcoming pilonidal cyst excision and the recovery period that will follow. If you have additional questions, be sure to ask your medical team. Your caregivers can provide information that specifically relates to the procedure that you'll be undergoing.

To learn more about minimally invasive pilonidal cyst treatment with the neoV Laser, use Adler MicroMed's Find a Doctor feature. We'll help you find a doctor in your area who uses this state of the art technology for pilonidal sinus care.

As with all medical issues, your physician is the ultimate source as to what procedure best fits your needs. Discuss all options and get a second opinion if you have any doubts. These articles are intended to be a source of general information only.