Underappreciated and Misunderstood
Pilonidal disease is a common condition affecting perhaps 1% of the young population in the United States. Few medical practitioners appreciate the prevalence of this condition, and it is surprising how misunderstood this condition is by medical providers including surgeons.
Way too many patients are having their condition improperly diagnosed. Many urgent care providers, pediatricians, and dermatologists are not confident in diagnosing a pilonidal condition. Many practitioners are confused by the appearance of a sinus opening, and I have seen patients who had their sinus opening biopsied or excised, which is a useless treatment and often worsens the condition.
Once a pilonidal condition becomes symptomatic it rarely improves without surgery. Having the proper surgical operation is essential as poorly executed procedures have high recurrence and re-operation rates. Traditional excisional operations place incisions or open wounds in the middle of a deep, airless cleft and can lead to a long or never-ending recovery that includes daily wound care and patient inactivity. It is the deep, airless cleft of affected individuals that is the cause of pilonidal disease. So operations that fail to make the deep cleft more shallow are likely to fail.
So, if you or your loved one has a symptomatic pilonidal condition, please do your homework, and understand that the Cleft Lift Procedure (better named the Pilonidal RAF for rotation and advancement flap) is the best operation for any patient requiring pilonidal surgery.
Very few surgeons are experienced with this operation so you may need to travel for your surgery. It’s well worth it and can give you your life back.