"Showered - Blood in the water - Checked - Holes in the coccyx - Googled - Oh no, a huge chunk of flesh must be cut away...!"
Source: Arztbewertungsportal Jameda
If you are looking for specific solutions for your pilonidal cyst or tailbone fistula, you will find a wealth of valuable information on the following pages to help you keep track of the various surgical techniques. You may then find that a "huge chunk of meat" does not have to be cut away at all, but that a minimally invasive measure is completely sufficient. A prerequisite is an examination by one of the few surgeons who are familiar with minimally invasive fistula surgery and can individually assess the success of pit picking and the like.
Standard surgery - the big hole on the buttocks
As a standard procedure for pilonidal cyst and tailbone fistulas, radical cutting of the cyst and the fistula system with open wound healing is almost exclusively performed worldwide and also in Germany. This means that the wound is not sutured up, but instead covered with tamponades and must slowly heal "openly", as this is expected to produce better long-term results. The procedure is simple and quick from the technical point of view. It is usually performed under anaesthesia, and patients often spend 1 to 2 days in a hospital.
For the patient this means:
The wound must be showered daily and a new tamponade applied. Due to the localisation of the wound, it is difficult to change the dressing independently, so an assistant is necessary at least in the first few weeks. Sitting and lying on the back is not possible in the first time after surgery, the wound also causes pain, which requires the regular use of painkillers, especially before changing dressings.
Hygienically, it's all such a thing. If the dressing is saturated with wound secretion, it should also be applied freshly in between, then the assistant must also be within reach. Wound secretion can be found in underwear and favourite jeans, possibly also on the bed sheet. Even if the wound is well cared for, it can occasionally smell something. Frequently the skin in the wound environment reacts to wound secretion and plaster material, becomes sore and develops redness, itching and red spots.
Everyday activities are out of the question, at least in the first few weeks. Sport and other leisure activities are not possible, the average time of incapacity for work is one month, or longer depending on the profession.
Statistically, wound healing takes 1.5 to 3 months. However, there are also known cases in which patients have had to struggle with their wounds for up to a year or longer.
Apart from the unpredictable duration of wound healing, this does not have to go without complications. It can stagnate, which means that nothing happens over a longer period of time, the wound doesn't want to get smaller. Or, for example, skin bridges are formed between the wound edges. This is an unmistakable sign that the body has surrendered in terms of wound healing. A new surgical intervention is necessary, which not only throws the patient back in time but can also wear him down psychologically.
Once the wound has finally healed, a nasty surprise can occur after months or even years: The pilonidal cyst and fistula have returned, which is the case in up to 35% of patients undergoing surgery using this method.
Surgery of the pilonidal cyst as 70 years ago or rather minimally invasive?
The radical cutting out of the pilonidal cyst and tailbone fistula system is a surgical method that has been carried out for 70 years in an almost unchanged technique.
Those who are affected by a pilonidal cyst and fistulas and inform themselves about Google will sooner or later come across indications that much smaller interventions for the treatment of the fistula are also possible, e.g. pit picking. Minimally invasive fistula procedures have excellent results in experienced surgeon's hands. Thus, in up to 80% of cases, pit picking leads in a short time to a permanent elimination of the problem with a low impairment on the patient, who can usually resume their normal daily activities after 0 - 1 day.
 |
| Lord Lucan, Trephine surgery 1, CC BY-SA 4.0 |
