Often patients ask me why their “cystectomy” won’t heal. Or, why it heals but then reopens.
These reasons are almost never the reason for the failure. However, believing that they are the reason for failure can send you off on the wrong direction trying to remedy the situation. Examples of the wrong direction are in the next paragraph.
Of course, if a patient had a huge excision that was left open (or fell apart after closure) it will take a while to heal, and the size does matter. But, there should be good, steady progress. If it is taking many months, the wound actually gets larger, or the wound seems to heal – but then reopens, or a new sinus tract opening appears, the cause has to do with the two reasons above.
When a patient gets to the point where it seems that it is just not healing, the original surgeon may suggest another excision! In general, this is the wrong approach, and just brings you back to square one. The best approach is one that will flatten the cleft and move the incision off the midline. My personal preference is the cleft-lift, which has been engineered to do exactly that. There are other flap procedures that may or may not work, depending on the expertise and experience of the surgeon performing the flap, but the cleft-lift is cosmetically the most appealing.
At our clinic we specialize in correcting the anatomy so that these wounds heal quickly. Our success rate with the cleft-lift in patients who have had previous operations is 95%. In the few patients who have problems, a revision of the cleft-lift is almost always successful as well – so overall, we get over 99% repaired and on with their lives. If you have been dealing with an open wound for more than two months without progress, contact us. We’re glad to help!
We routinely take care of patients with pilonidal cysts, non-healing pilonidal wounds, and pilonidal abscesses with great success in the pediatric, teen, and adult age groups.