I feel that we doctors are in a rut when it comes to the care of pilonidal problems.  ER, Urgent Care, Pediatricians, Dermatologists, and Internists often have a tough time making the diagnosis and even a more difficult time directing the proper path for treatment.  More concerning is that many surgeons who ultimately treat the problem often make it worse by performing operations that can make the problem worse and more difficult to treat.

Here’s a story of one such patient of mine:

Tom started his senior year of college.  He was excited and looking forward to completing his major in history and enjoying sports and a busy social life.  In the fall he began to have discomfort by his tailbone and daily drainage in his underwear. He went to the on-campus infirmary and was told that he had a pilonidal sinus.  He was referred to a local surgeon who told him that he needed surgery. The surgeon told him that this was routine and that he did it all the time. So, Tom had surgery. What he didn’t expect was that the surgeon was going to carve a huge hole in his backside.  He had a huge wound. He couldn’t go to class. He required wound care. For the rest of the semester he had to take classes on line.  

January came.  It was time to start Tom’s last semester.  But Tom still had a huge open wound on his backside.  He was going to a wound clinic three times per week. The doctor at the wound clinic chose to put a wound vac on his backside.  He was told that he could attend class again. How humiliating. Going to class with his peers and a vacuum apparatus was on his rear end. For all to see.  Three months later, the wound still wasn’t closed. It was marginally smaller.

By this time, Tom’s family had read about the cleft lift procedure and travelled to San Francisco to meet with Dr. Sternberg, who performed a cleft lift procedure on Tom.  One week later, Tom was attending class without any kind of dressing or vac. One month later, Tom was back to sports and reentering the social scene.

Don’t suffer with a pilonidal wound.  Seek help. The cleft lift procedure is the best way to be cured of your pilonidal problem, hands down.