19 year old female s/p wide excision and primary closure fo | Figure 1

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Surgery

19 year old female s/p wide excision and primary closure for pilonidal disease over the previous year. Each failed, leaving her with a large wound. Here is the early post op result of a cleft-lift extended to the perianal area. #pilonidal #cleft-lift

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18 year old female presents with a persistent open wound, very close to the anus, 10 months after excision with packing for pilonidal disease. Treated with a cleft-lift, which flattened the deep cleft, brought the incision to the left of the midline, and allowed complete and rapid healing. Note the hyperpigmentation in the cleft, a sign that the skin is chronically moist and irritated.
So, although there is much controversy over how to treat patients with pilonidal disease with minimal symptoms, a cleft lift is a reasonable option with very high patient satisfaction and excellent results. More about the actual results in this article www.bit.ly](https://app.figure1.com/cdn-cgi/image/format=auto,quality=85,width=168,height=168,fit=cover,gravity=auto/https://figure1-pro-prod.imgix.net/cases/images/a65a5ce03f1d69cd15405e4b3f1e56628d48140fcc771764eea294f0c5652bbd.png)
29 year old female with a history of one pilonidal abscess, and persistent mild pain. Residual pre-op findings consist of two midline pits. This patient opted for a cleft lift as her primary procedure. She wanted one procedure that had a low chance recurrence.
The top series of 4 images shows the pre-op appearance and the proposed excision.
The bottom series of images shows the appearance immediately after surgery, at one week and at two months.
A recent analysis of patient surveys asked the question about how they felt about the cleft lift as a patient's first operation for pilonidal disease. Whether the patients had previous failed surgery or not, the vast majority (78.2% and 79.6% respectively) felt that the cleft lift was an appropriate first operation for pilonidal disease. A minority patients felt that a less invasive operation should be tried first. Overall, Of the 500 respondents, 494 (98.8%) were “extremely satisfied” or “satisfied” with their procedure. Details here: www.bit.ly
So, although there is much controversy over how to treat patients with pilonidal disease with minimal symptoms, a cleft lift is a reasonable option with very high patient satisfaction and excellent results. More about the actual results in this article www.bit.ly

Ultrasound of the gluteal crease in a patient with a pilonidal cyst shows a hypoechoic structure with mild surrounding hyperemia and internal complexity. The internal contents are mobile with compression of the lesion. A pilonidal cyst represents an infection of a hair follicle and usually occurs at the natal cleft. Pilonidal cysts more commonly occur in males due to body hair distribution.

pilonidal cyst

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