A pilonidal cyst is a cystic skin condition that occurs in the region of the sacrum to the anus. This disease is also called pilonidal cystic disease, pilonidal sinus disease or intergluteal pilonidal disease.
This is a common type of cyst located in the crease of the buttock region. There are more than 70,000 reported cases yearly in the US alone.
These cysts are caused by a skin infection and often have ingrown hairs and debris inside. If left untreated, pilonidal cysts can cause large abscess formation in the region.
During World War Two, pilonidal cysts were called “Jeep driver’s disease” because they were commonly seen in the drivers of those vehicles.
High Risk Populations for Pilonidal Cysts
- Men are 3-4 times more likely to develop these cysts than women
- Average age of development is between 20-35 years of age
- Those who sit most of the day such as truck drivers and office workers
- Obesity
- Very thick or coarse body hair
- Can be hereditary, especially in populations with thick body hair
Symptoms
- Pain is the common symptom at the base of the spine
- Large swollen area that is red and tender
- Draining pus or blood
- Fever, nausea, fatigue
Diagnosis
Rarely, testing is needed other than a physical exam by the healthcare professional.
CT or MRI is only needed if sinus cavities have formed.
Treatment
- Draining of the cyst usually done immediately in the doctor’s office
- Injections of sclerosing agents such as phenol
- Antibiotics do not cure pilonidal cysts but are needed if there is an abscess formation
- Laser therapy can be used to remove hair in the area as a preventative measure for future formation
- Warm compress to promote drainage and to sooth the skin. Packing with gauze can also be used
Surgery
Recurrent pilonidal cysts or cysts that have formed sinus tracts need to be surgically removed. Surgery will remove the cyst entirely, and the types of surgical procedures are dependent on what is encountered at the time of surgery.
The surgical site can be left open and packed, the wound edges sutured open called marsupialization or a flap created and closed with a graft from another area.
Post-operative healing can be painful with drainage and frequent changes of packing. Infection is certainly a risk post operatively. Even after surgery, a pilonidal cyst can reoccur and remain as a chronic condition.
Pilonidal cysts can pose long term health issues.
Systemic infection is possible causing other diseases such as diabetes to get out of control.
Cancer, although rarely caused by pilonidal cysts , can sometimes happen (squamous cell carcinoma).
Platelet Rich Plasma and Pilonidal Cyst Treatment
Platelet Rich Plasma is the autologous concentration of blood derived platelets rich in cytokines and growth factors. PRP has been shown to aid in the post-surgical healing of many disease states and recent literature has shown success in the healing of the wounds caused by removal of pilonidal cysts. PRP is also anti-infective and aids in the prevention of post-operative infections. The usual post-operative period of removal to healing is usually 3-6 weeks or longer. Platelet rich plasma has been proven to reduce healing times with a significant reduction of pain and an early return to activities of daily living.
Studies
BMC Surg 2020 Sep22;20(1):212 PMID 32962673
Background: Sacrococcygeal pilonidal sinus disease is an infection of the skin and subcutaneous tissue at the upper part of the natal cleft of the buttock. Excision and healing by granulation “lay-open” method is still more preferable than other methods of midline closure or using flaps but the healing time is lengthy. The present study was performed to assess the healing promotion of platelet rich plasma on the pilonidal sinus wounds treated by the “lay-open” method.
Conclusion: PRP injection is an effective new technique in accelerating the healing of pilonidal wound after surgery with a significant decrease in post-operative pain, complications and an early return to work.
BMC Surg 2021 Oct 21;21(1):373 PMID 34670534
Background: Pilonidal sinus is a common health problem. The current study aimed to compare the impact of autologous platelet rich plasma with that of minimally invasive techniques in terms of pain reduction, return to work activities, quality of life, duration of wound healing after open excision and secondary closure.
Conclusion: PRP application improves postoperative recovery in that it speeds patients return to daily activities, reduces their pain scores and increases quality of life.
World J Surg 2022 Dec;46(12): 2910-2918. PMID 36064868
Background: Pilonidal disease can be a debilitating condition which carries significant physical and economic burden. This systemic review and updated meta-analysis presents evidence for the use of platelet rich plasma for wound healing following open and minimally invasive sacrococcygeal pilonidal surgery.
Conclusions: This systematic review and updated meta-analysis provide further evidence supporting the use of PRP for wound healing in sacrococcygeal pilonidal disease. PRP was demonstrated to significantly reduce healing time, postoperative pain and time off work in the open surgery group.
Juventix Regenerative Medical is an industry leader in the regenerative medical field. Our platelet rich plasma kits are FDA approved and designed for safety and effectiveness. They are cost effective and easy to use.
Juventix Regenerative Medical offers a patent pending LED Activator to activate the platelets and begin the regenerative process. This critical step in the release of cytokines and growth factors is accomplished with light and not by the addition of other chemicals such as thrombin or calcium chloride.
Juventix Regenerative Medical supplies a bio-incubator that transforms the platelet rich plasma into an injectable platelet rich fibrin. The PRF commonly called “the second generation of platelet products” has a broader range of clinical applications especially applicable in the wound care field.
RESTORE, REVIVE, REGENERATE- JUVENTIX REGENERATIVE MEDICAL
Regenerative Regards,
Dr. Robert McGrath
