Pilonidal FAQsShomaf Nakhjo, DO Advanced Minimally Invasive Surgery

Pilonidal Disease affects people in different ways. Some people may have one flare-up and never experience symptoms again, while others may have problems every couple months to weeks. If your every day life is being affected by the disease, surgery should be considered. Unfortunately, no matter how many incisions and drainages you get, this will not cure the disease. The Cleft Lift is the only procedure proven to heal people with Pilonidal Disease, and that is because it removes the whole sinus tract so the cysts cannot reform. However, if you are not experiencing severe and frequent flares, conservative management is possible. Here at our center, we are always available to see patients with any problems, or even prescribe antibiotics if necessary. We pride ourselves on always being there for the patient, so don’t ever hesitate to call. We will get you in ASAP because we know how painful this disease can be.

When a pilonidal cyst is actively inflamed, an infection occurs, and the pus needs to be drained. By making a small incision for the fluid to drain out, this also helps rid the patient of infection. We also like to put our patients on antibiotics as well. They are instructed to take Sitz baths to help express any remaining fluid, and to wash the area daily with hibiclense. This usually relieves the majority of the pain and patients feel much better after the procedure. In addition, we will send a culture of the fluid to make sure each patient is on the correct antibiotic.

We do recommend general anesthesia as the procedure is much more comfortable for the patient. During the procedure you are laying on your stomach, bent at the hips. We use a long acting pain medication called Exparel, which lasts up to 72 hours, and makes patients very comfortable. Our patients go home the same day and are up and walking as soon as they leave the hospital. We also give Tramadol, which is a stronger pain medication, but the majority of patients tolerate the procedure with Advil and Tylenol. We have many patients state that having a flare-up of the pilonidal cyst is exponentially more painful than the procedure itself, and rest assured, you won’t have to deal with those every again!

Yes, the Cleft Lift Procedure requires a drain due to the amount of tissue that needs to be rearranged during the surgery. Your body can create fluid which needs to be removed or else the incision can break down. Our patients usually have a drain in place for 3-5 days. Our Physician Associate will call you daily to check on the outputs. Once the drain is ready to be removed, you can do this yourself at home, or come into the office, but either way is very simple, with no pain! We always say its better to have a drain and not need it then to need it and not have it, otherwise significant complications can occur.

At Dr. Nakhjo’s office, we try to make things as easy as possible for the patient. We used to use a bulky dressing that was difficult to keep clean. Now we use multiple layers of absorbable sutures and then skin glue, so nothing has to be removed in the office (except for the drain). Patients are able to shower the next day with the skin glue, therefore, preventing infections. We also suggest showers after every bowel movement to keep the are as clean as possible. And to be extra cautious, we give each patient one week of antibiotics to prevent infections.

Many people who suffer with pilonidal disease have significantly high recurrence rates and flare-ups that cause discomfort and disruption to daily living. We specialize in the Cleft Lift Procedure which cures our patients of pilonidal disease and is the only one that truly works. Many patients come to us after multiple incisions and drainages or unsuccessful operations. Come in to talk about this life-changing procedure and get rid of your pilonidal disease for good!