WHAT IS A PILONIDAL CYST OR ABSCESS?
A pilonidal cyst is a fluid pocket near the tailbone (coccyx). These usually occur when hair follicles get irritated and cause a reaction below the skin. When the pilonidal cyst gets infected, it becomes a pilonidal abscess. The infection is a pus filled cavity.
This disease is more common in men than women and occurs from puberty to middle age.
WHAT ARE THE SYMPTOMS?
Symptoms vary. When small and not infected, a small dimple can be felt. When the cyst becomes infected, an abscess, then a painful lump is found. Fevers, chills, and draining pus may occur.
After one episode of a pilonidal abscess, a tract or sinus may form. This causes recurrent episodes to happen. Surgery is almost always required for recurrent pilonidal abscesses.
HOW IS A PILONIDAL CYST OR ABSCESS TREATED?
For the acute, or immediate phase, lancing (an incision to get rid of the pus) is done. This is usually done in the office and produces immediate relief. Once the acute infection is controlled, surgery is scheduled. Pilonidal abscesses can be complex with tracts in different directions. With the assistance of an anesthesiologist, unroofing of the abscess is done. The infected cavity and tracts are removed. Sometimes the wound is closed, sometimes the cavity is left open to heal.
WHAT CARE IS REQUIRED AFTER SURGERY?
Daily dressing changes are required if the cavity is left open. Before showering, the gauze is removed, then water is allowed to clean the wound. After the shower, a new gauze is placed. This may last 3-6 weeks. Patients can go back to work when they are ready (1-2 weeks).