ggparker14
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procedure: pilonidal cystectomy (Bascom type excision)
Attention was turned to the midline pits. At the superior edge of the the inflamed area, there is a 1 cm opening from which some purulent exudate was expressible. Approximately 3 cm below this area, there was a 2-3 cm area with multiple small dilated pits in close proximity. An 11 blade knife was used to excise the superior pit and the area of skin containing the confluent smaller pits. Gelatinous inflammatory tissue was encountered followed by large plugs of hair.
A 4 cm incision was made in the left lateral buttock just lateral to the excised pits. A tunnel was made between the open lateral incision and the pilonidal pseudocyst area. The indurated avascular pseudocyst walls were completely excised and the gelatinous material against the dermis was removed with a curette. The open wound cavity was irrigated vigorously multiple times to remove any remaining debris and hair material. Examination revealed complete removal of all the pilonidal cyst material. Bleeding points within the subcutaneous tissue and dermis were controlled with electrocautery. The midline pits were reapproximated with interrupted sutures of 3-0 chromic gut suture. The wound cavity was packed through the laterial incision wiht a single 4x4 gauze soaked in diluted Betadine.
Attention was turned to the midline pits. At the superior edge of the the inflamed area, there is a 1 cm opening from which some purulent exudate was expressible. Approximately 3 cm below this area, there was a 2-3 cm area with multiple small dilated pits in close proximity. An 11 blade knife was used to excise the superior pit and the area of skin containing the confluent smaller pits. Gelatinous inflammatory tissue was encountered followed by large plugs of hair.
A 4 cm incision was made in the left lateral buttock just lateral to the excised pits. A tunnel was made between the open lateral incision and the pilonidal pseudocyst area. The indurated avascular pseudocyst walls were completely excised and the gelatinous material against the dermis was removed with a curette. The open wound cavity was irrigated vigorously multiple times to remove any remaining debris and hair material. Examination revealed complete removal of all the pilonidal cyst material. Bleeding points within the subcutaneous tissue and dermis were controlled with electrocautery. The midline pits were reapproximated with interrupted sutures of 3-0 chromic gut suture. The wound cavity was packed through the laterial incision wiht a single 4x4 gauze soaked in diluted Betadine.
