This is usually the first procedure necessary to cure a pilonidal cyst, since the abscess is the first sign of the disease. Its purpose is to relieve the infection that has been trapped under the skin, generating intense pain in the patient. It is also called “lancet” or “incision and drainage”.

This is the most commonly used treatment for an infected cyst. It consists of a simple procedure, performed on an outpatient basis in the office, involving the administration of local anesthesia to numb the skin, before proceeding to make an incision in the cyst to drain the fluid and pus, after which it is filled with gauze (which is changed periodically) and left open until it heals, in about 4 weeks.

It is the procedure that consists of removing the diseased tissue and sewing it up, hoping that it will heal in the next few days. This is a fairly simple operation, but can be disappointing; as it may look like it will heal well in the next few hours and then separate, usually attributed to infection, but that is usually not the case; as it falls apart because it is down in the crevice. In these cases, prolonged wound care may be needed for the wound to heal.

In other cases only an excision of the pilonidal cyst is usually applied, which means that the diseased area is removed, but no attempt is made to close the wound. Instead, it is left to heal on its own, which usually takes a few months (secondary healing). To do this, the patient will require frequent dressing or packing changes to help it close.

It is a popular operation among surgeons because patients and surgeons do not suffer the disappointment when a closed wound is separated a week or two after primary surgery. In such a case, the surgeon understands that wounds in the gluteal cleft do not usually heal easily, and by leaving it open he is accepting this.

Another procedure applied to treat pilonidal sinus is the Pit Picking or Bascom Operation, which consists of making small incisions around the midline pores and removing the small sinus tracts, which make their way under the skin. It is complemented with a second incision on one side and, through it, the hairs or debris are swept away.

It is recommended for minimal or beginning disease, as depending on the severity of the case, it may not be 100% effective. In certain cases it does not work, as the deep gluteal cleft remains and often a new pilonidal disease develops.

On the other hand, there are other newer procedures that may or may not be successful in the treatment of pilonidal disease, such as EPSIT. With this method a small endoscope is placed into the opening of the sinus tract and the hairs and inflammatory tissue are removed.

Basically, it is a variation of pit picking treatment and although it has its indications, it also has its limitations. For example, it does not flatten the cleft, so it does not solve the main problem.

In this procedure, the area of the disease is removed and skin is taken from another part of the body and grafted over the wound. In such a case, although operations for pilonidal disease are usually performed on an outpatient basis, it may require hospitalization for immobilization and wound care while the graft heals.

It is often referred to as a flap procedure, in which a flap of skin is moved from one area to another. Its name is Z-plasty, since the final scar has three Z-shaped ends.

Although its application may be required, its disadvantage is that it must be done very aggressively to flatten the gluteal cleft. On the other hand, the cosmetic results are not very attractive, and if it fails, it is difficult to correct secondarily.

Pilonidal Laser Surgery in Madrid is applied to treat the problem of pilonidal cyst or sinus, which occurs when hair follicles become infected developing a pilonidal abscess, usually generating pain, reddening of the skin, pus or blood oozing (with an unpleasant odor), fever and nausea, among other symptoms.

Laser treatment of pilonidal disease consists of an outpatient procedure without hospitalization, in which the specialist makes a small incision in the skin, of approximately 0.5 cm, and applies a careful cleaning of the sinus tract with a curette. He then proceeds to the application of laser energy by means of a radial fiber connected to a set of diode laser, which has been introduced into the tract.

This laser surgery can be performed under general anesthesia, which keeps the patient completely asleep, or under regional anesthesia, which numbs the patient from the waist down, always under the supervision of a specialist in Coloproctology, in charge of the diagnosis and treatment of diseases of the colon, rectum and anus.