Recurrent or persistent pilonidal disease
Some patients may suffer from persistent non-healing operative wounds. Inadequate postoperative surveillance and care are an important cause of postoperative wound healing failure.
Improper healing of operative wounds and recurrent disease, are possible outcomes of any surgical method managing pilonidal disease. About 15-25% of operated patients (up to 40%, according to several medical publications), may need additional treatment and surgery to achieve final cure. One of the reasons that no surgical method can guarantee 100% persistent cure, lies in the list of risk factors for occurrence of pilonidal disease in the first place. These factors may still be active after surgery and promote formation of new pits and cavities, months and years after surgery. Formation of new pits or fistulas will obviously require additional surgery.
Healing of such wounds can still be achieved without additional surgery by strict removal of hairs from within the wound and from the surrounding skin (by a caregiver), lavage and constant buttocks spreading bandage. Cleaning of the wound by a surgeon may be needed occasionally (curettage and debridement). (Read the chapter on postoperative treatment).