GLOSSARY OF PILONIDAL TERMS

Cleft-lift procedure

An off-midline pilonidal cystectomy technique which aims to flatten the intergluteal cleft. This technique is associated with superior wound healing and dramatically low recurrence risk.

Drain

A silastic side-holed tube placed deep to an incision and connected to a self-suctioning reservoir bulb. The use of this tube prevents the accumulation of fluid in the postoperative period.

Excision

Surgical removal of diseased tissue.

Incision and drainage

The lancing of a pus-filled abscess, often in the fatty layer below the skin. It is a small procedure usually done with local anesthetic and intravenous sedation.

Intergluteal cleft

The natural midline fold that lies between the buttocks. The “microenvironment” present within the cleft, one of high bacterial load and moisture, is a predominant factor in pilonidal cyst formation.

Inferior midline pits

Enlarged and visible skin pores found at the central aspect of the cleft. A visible pit indicates an accumulation of hair shafts within the pore. An inferior midline pit will often evolve into a pilonidal abscess or sinus tract.

Packing

Cloth strips, often imbedded with iodine, used to fill an abscess cavity following incision and drainage. They serve to further draw out purulent fluid from the cavity and also to keep the drainage-tract open.

Pilonidal abscess

An acutely infected pilonidal cyst. The abscess is filled with purulent fluid or “pus” under high pressure. The overlying skin is red, warm, swollen, and extremely tender.

Pilonidal cyst

A cavity just under the skin filled with hair shafts and debris. It is most often seen in the intergluteal crease. It becomes symptomatic when an abscess or sinus tract develops.

Pilonidal cystectomy

The surgical removal of pilonidal disease. Multiple techniques exist, and most are completed with a closed wound. This procedure contrasts with the incision and drainage, in which the primary aim is to drain pus from a pilonidal abscess. Pilonidal cystectomy is electively done in the absence of acute infection. General anesthesia is the norm.

Pilonidal sinus tract

A smoothly-lined canal originating in a pilonidal cyst and leading to the skin surface. It serves as a path for chronic drainage of infected cyst fluid. The drainage may be slow or intermittent. A pilonidal sinus tract may develop at the site of a surgical lancing, or it may spontaneously appear.

Pit-picking

A minimally invasive pilonidal cystectomy technique in which hair shafts, debris, and inflammatory tissue are bluntly extracted via small cuts in the intergluteal cleft skin.

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