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Surgery for Tailbone Cysts: Pilonidal Disease Bascom Procedure © Steven C. Immerman, M.D., FACS, 2008 What is pilonidal disease ? A pocket of infection that occurs in the tailbone area is called a "pilonidal" cyst or abscess. These infections begin as enlarged pores in the crease between the buttocks. Pieces of hair can enter these pores, burrow their way underneath, and cause infection under the skin. Sometimes this causes minor irritation, but other times it can cause a painful pocket of infection that has to be surgically drained (lanced). Different patients have different degrees of symptoms from this. Once pilonidal infections begin, they may continue to cause problems unless surgically treated. Healing is very poor in this area after surgery. The main reason for the healing problems is that pilonidal disease develops deep within the buttock crease. This area is closed off from the air almost all the time. The skin does not tolerate this type of situation well, and most of the problems from pilonidal disease are related to this deep cleft. What kind of surgery can be done? There have been many different operations devised to take care of this problem. The reason that there are so many operations, is that no one particular operation works well in all situations. However, one of the best operations is called Cleft Closure (also called the Bascom procedure, or "cleft lift"). This operation flattens out the crease between the buttocks so there is no longer a deep crevice. In our experience, over the last ten years, this has been over 95% effective in removing the infection, allowing healing, and preventing recurrence. Because of the unusual success rate that we have had at with this operation at Evergreen Surgical in Eau Claire, Wisconsin, it is our procedure of choice for all cases of significant pilonidal disease. This procedure is done as an outpatient under general anesthesia. The pockets of infection are removed and the buttock crease is adjusted. After the operation, the buttock crease will be slightly flatter. This usually heals in a couple of weeks without any packing or special dressings. There is a small drain that is placed and removed in a few days. At Evergreen Surgical we have had extensive experience with pilonidal disease. Not all surgeons perform cleft closure, but we are very excited about the excellent results that we have achieved with our patients over the last fifteen years. We welcome self referrals from patients with this problem, and can make arrangements to see out of town patients for care of this frustrating problem.
If you would like more information, or would like to make an
appointment, please call our office directly at 715-832-1044, or email us at
contactus@EvergreenSurgical.com.
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