Advertisement

Pilonidal Cyst Disease

Chapter

Abstract

Pilonidal sinus disease is a chronic subcutaneous inflammation in the upper part of the gluteal cleft. First described by Mayo in 1833, this “nest of hairs” was aptly named by Hodges in 1880, who first used the term pilonidal sinus (Latin pilus hair, nidus nest). For some time, the midline nature and presence of hair in the wound misled physicians, who hypothesized that pilonidal disease was an infection of a congenital cyst or pit of the sacrococcygeal area. However, over the past 60 years, it has been argued convincingly that this disease is acquired and the “cystic” nature of the abscess cavity is likely due to chronic infection and inflammation. This acquired etiology is supported by: (1) the occurrence of similar lesions in other sites of the body, occasionally associated with minor trauma (interdigital spaces of hair stylists and barbers), (2) the increased incidence associated with a sedentary occupation or lifestyle (jeep-drivers disease of World War II), and (3) the absence of typical histological features in the pilonidal “cyst” to suggest a congenital origin (absence of hair follicles and skin appendages despite the presence of hairs in the cyst wall, lack of epithelium of the internal cyst wall).

Keywords

Primary Closure Pilonidal Sinus Abscess Cavity Hidradenitis Suppurativa Pilonidal Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Bascom J. Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery. 1980;87:567–72.PubMedGoogle Scholar
  2. Bascom J, Bascom T. Failed pilonidal surgery: new paradigm and new operation leading to cures. Arch Surg. 2002;137:1146–50; discussion 1151.Google Scholar
  3. Buie LA. Jeep disease (pilonidal disease of mechanized warfare). South Med J. 1944;37:103–9.Google Scholar
  4. Cintron JS, Abcarian H. Pilonidal disease. In: Cameron JL, editor. Current surgical therapy. 7th ed. St. Louis, MO: Mosby; 2001. p. 316–22.Google Scholar
  5. Hull TL, Wu J. Pilonidal disease. Surg Clin North Am. 2002;82: 1169–85.CrossRefPubMedGoogle Scholar
  6. Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg. 1992;62: 385–9.CrossRefPubMedGoogle Scholar
  7. Kitchen PR. Pilonidal sinus: experience with the Karydakis flap. Br J Surg. 1996;83:1452–5.CrossRefPubMedGoogle Scholar
  8. McCallum IJ, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ. 2008;336:868–71.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

Personalised recommendations