For decades, surgeons have struggled with the handling of the wound following pilonidal cyst removal. Early on, the most perfect-appearing midline closures would invariably fail. Some surgical schools theorized that tension was the problem, and devised elaborate skin rearrangements (flaps) to offset this. Others tried skin grafts from the thigh with minimal success. One wound…
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At PTCNJ, the drain used in the cleft-lift procedure is called a Blake drain. It is a closed-suction device used to evacuate clear fluid called serum, which tends to be produced under a closed surgical wound. The drain is made of soft flexible plastic-like material. It consists of a thin tube, part underneath the skin…
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At the most conservative end of the treatments spectrum, a nonsurgical depilatory technique, i.e. hair removal, may be used. This may be application of a topical agent (e.g. Nair), shaving, or waxing. Laser ablation is also an option but has limitations and setbacks. We add to this nonsurgical approach lifestyle modifications, the most important of…
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Some pediatric patients develop pilonidal disease. With few exceptions, it remains mild throughout the adolescent years. It is manageable with lifestyle modification and medication alone. If surgical procedures are required, they are smaller procedures such as abscess drainage and pit-picking. At Pilonidal Treatment Center of New Jersey, patients 16 and under who present with pilonidal…
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The question to ask of any prospective surgeon offering to treat your pilonidal disease is definitely not “How many pilonidal surgeries have you performed?” The answer is often inflated. The more revealing question to ask is “What percentage of your practice does pilonidal disease comprise?” The answer must be >75%, or you have not found…
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Not a response you should ever hear from your primary medical doctor. Sadly, the story is a true one. This is the reponse that a caring parent received when she reached out to her PMD regarding her son’s newly diagnosed pilonidal sinus. The story comes from a skilled pilonidal specialist who spent much of his…
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The question is a good one. The majority of pilonidal surgeons in the US have completed a 5 year general surgery residency. Some have gone on to perform colorectal surgery, pediatric surgery, and plastic surgery fellowships. These fellowships are generally 2 years in duration. No pilonidal fellowship currently exists in the Western world. Regardless of…
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Pilonidal cysts are not well understood, even by many surgeons treating them! As we will explain, this lack of understanding contributes to some of the surgical mismanagement that we see. It is thus important for us to define exactly what human tissue comprises a pilonidal cyst, and its mechanism of formation. By extension, we will…
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There are several surgical options for refractory pilonidal disease. Multiple such options are offered at Pilonidal Treatment Center of NJ. Before listing them, let us define what “refractory” pilonidal disease is. First, any pilonidal patient who has recurrent (>1) pilonidal abscesses has refractory disease. These abscess episodes may require surgical drainage, antibiotic therapy, or both.…
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The period before any surgery can be scary and nerve-wracking. It is a fearful period full of “what if’s”. If you are a Pilonidal Treatment Center of NJ patient who has chosen and awaits the cleft-lift procedure, let me, the Medical Director, allay your fears. First, bleeding risk is neglible in pilonidal cystectomy. This is…
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