Infections can happen after any operation. The incidence depends greatly on the surgeon and the particular situation. Infection rates as high as 13% have been reported with the cleft lift procedure. In our clinic the overall infection rate is about 3%. We wish it were zero percent, but there are no operations completely free of possible infection, and an infection rate below 2% with any operation is unusual. Considering the location of pilonidal disease, and the contamination of the area with bacteria within cysts, sinuses and wounds, 3% is a very acceptable infection rate. Below I will discuss the strategies we use to prevent and deal with wound infections.
However, in spite of these strategies, infections still do occur. How serious a problem this will ultimately be depends greatly on the construction of the cleft lift. One of the consistent problems that occurs with infection is that a portion of the incision separates, and it is usually in the lower third. If the cleft is flattened and the incision is nicely placed off the midline, this separation usually heals with time. However, if the incision is in the midline, and in a fold, it may become more of a long-term issue. This web page demonstrates the differences between a cleft lift where the incision is well placed, versus the opposite.
Then, we have to be patient and allow the infection to subside and the wound to heal. Once an infection is apparent, the wound may separate a bit more over the next week. Then, it stabilizes but doesn’t seem to be really making any progress for another 3-4 weeks, and then it seems to start closing steadily, and is usually healed between 8 and 12 weeks from the surgery.
Here is a series of photos showing the typical evolution of the separation from a wound infection:
If the cleft lift incision is off the midline these usually heal, but an infection slows down healing and can be frustrating. It is important to keep us posted on your situation, follow our instructions, and be patient. Complete healing will take longer than usual, but the infection usually will not sabotage the success of the cleft lift.