What is the diagnosis and treatment for a pilonidal (pilonidal) cyst?

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From the Research

Diagnosis of Pilonidal Cyst

  • The diagnosis of pilonidal cyst is typically based on clinical presentation, with the disease often manifesting as a chronic infection of the hairy skin in the area of skin wrinkles, most commonly in the natal cleft 1.
  • The pathomechanism of pilonidal sinus disease has not been conclusively clarified, but it is assumed that hair in the natal cleft contributes significantly to the formation of the disease 1.

Treatment Options for Pilonidal Cyst

  • Surgical excision remains the gold standard for treating pilonidal disease, with various techniques available, including wide excision without closure, flap closures, and less invasive procedures such as pit picking and fistuloscopy 2, 1, 3.
  • The choice of treatment depends on the patient's needs and the severity of the disease, with excision and open granulation serving as a standard procedure for comparison with other treatment options 1.
  • Less invasive procedures, such as pit picking, have been shown to have advantages including faster recovery, no need for hospitalization, and low complication rates 3.
  • Treatment options can be categorized into three groups: standard treatment of excision and subsequent open wound treatment, locally destructive treatment that preserves the skin, and excision and plastic reconstruction 1.

Considerations for Treatment

  • The management of pilonidal disease must strike a balance between recurrence and surgical morbidity, with the ideal treatment being simple, cost-effective, causing minimal pain, and requiring minimal time off from school or work 2.
  • Patient-oriented therapy planning is essential, with the patient being taught about the different treatment options and a treatment recommendation being given based on their individual needs 1.
  • The treatment of pilonidal disease can have a significant impact on the quality of life of the affected person, and the choice of treatment should be made with consideration of the potential for morbidity, wound healing disorders, and recurrence 2, 1.

References

Research

Management of pilonidal disease.

Current opinion in pediatrics, 2018

Research

Treatment Options for Pilonidal Disease.

The American surgeon, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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