Outcomes of Emergency Radical Surgery of Pilonidal Cyst Complicated with Acute Abscess

Ye.V. Tsema, A.M. Kulyk


The objective of the study — to compare the outcomes of emergency radical surgical treatment of patients with pilonidal cyst complicated by an acute abscess, using traditional techniques and less traumatic techniques
Material and methods. The article deals with outcomes of surgical treatment of 174 patients with acute pilonidal abscess, who underwent emergency radical surgery. 26 (14.9 %) patients underwent a wide excision of the pilonidal cyst with marsupialization of the operative wound. 31 (17.8 %) patients underwent a wide excision of the pilonidal cyst with restoration of wounds by vertical adapting multistich sutures. 29 (16.7 %) patients underwent wide excision with wound closure by horizontal U-shaped sutures («tourniquet» suture). In 34 (19.5 %) patients, surgical intervention is carried out according to the procedure Bascom I. In 54 (31.0 %) patients the treatment was carried out by the proposed method of ultrasonic curettage of pilonidal cyst. Long-term results of treatment were followed in period of 1 to 3 years.
Results and discussion. In operated patients we detected 56 (32.2 %) cases of postoperative wound suppuration, 19 (10.9 %) cases of primary and 24 (13.8 %) cases of secondary dehiscence of postoperative wound, 14 (8.0 %) cases of postoperative hematomas of postoperative wound and 19 (10.9 %) relapses of pilonidal cyst. Significantly lower (P = 0.02) postoperative recurrence of the disease and non-inflammatory complications of treatment was found in patients who were operated urgently using surgery Bascom I or ultrasound curettage of pilonidal cyst.
Conclusions. Using less traumatic methods of treatment (surgery Bascom I, ultrasonic curettage of pilonidal cysts) can significantly reduce (P = 0.02) the incidence of postoperative complications and recurrence of the disease.


acute pilonidal abscess; pilonidal disease; radical surgery; operation Bascom I; ultrasonic curettage


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