Pilonidal disease was described in 1833. Today, pilonidal disease describes a spectrum of clinical manifestations, from asymptomatic hair-containing cysts and sinuses to large symptomatic sacrococcygeal abscesses that tend to recur.
The incidence of pilonidal disease is about 26 people per 100,000 people. Pilonidal disease is 4 times more common in men than in women. It occurs predominantly in white patients, decreases after age 25, and rarely occurs after age 45. Sedentary lifestyle and obesity occurs in a significant percentage of patients with pilonidal disease.
The mechanism of hair cyst formation:
Hair penetrates the subcutaneous tissues and creates sinuses and cysts.
In summary, 3 pieces are effective in this process:
- Hair
- Force causing penetration of hair
- Vulnerability of skin
symptoms:
Pilonidal disease can appear in several different disease states and may be asymptomatic, but the most common form that is observed is a painful and swollen lesion in the sacrococcygeal region about 4-5 cm posterior to the anus. Sometimes spontaneous discharge may have occurred before consulting a doctor.
Patients may present with intermittent swelling and discharge, including purulent, mucous or bloody fluid from the area. Chronic pilonidal disease often presents as recurrent or persistent drainage and pain.
Risk factors for pilonidal disease include:
male gender, hirsute people, Caucasian race, sedentary jobs. Family history is seen in 38% of patients with pilonidal disease. Obesity is a risk factor for recurrent diseases.
treatment :
Depending on the patient’s condition, surgical treatment is a suitable option for the patient. There is a possibility of recurrence after surgery. It is better to use the hair laser to remove the hair in that area after the surgery and complete recovery of the skin.
Surgery is performed on an outpatient basis with local anesthesia. The duration of the operation is about one hour.
I perform the pilonidal surgery with a surgical incision by laser, which makes the bleeding during the operation very little and the pain and bleeding after the operation is very little compared to the operation with a surgical blade.
The recovery period in this type of operation is much less than the operation with a blade.
Regarding pre- and post-operative care, refer to the section (pre- and post-operative care)
