Rhomboid Flap Surgery for Pilonidal Cysts & Sinus
Allen Kamrava, MD, MBA, FACS, FASCRS· Board-certified in Colon & Rectal Surgery and General Surgery· Published · Reviewed
- Setting
- Operative
- Anesthesia
- General anesthesia, in the operating room
- Back to work
- Most people return to normal activity over several weeks — recovery is longer than with the office-based options
When you’re looking for relief from the uncomfortable and painful symptoms associated with a pilonidal cyst, the rhomboid flap technique is a smart option to explore for pilonidal cyst excision. Unlike standard surgeries that require a long recovery time due to an open wound, a rhomboid-flap surgery ensures a patient’s comfort while providing an effective solution for pilonidal disease.
As one of the most experienced surgeon’s with this innovative technique, Dr. Kamrava provides his patients with unparalleled levels of care. He is a fellowship-trained and board-certified expert who has extensive experience treating pilonidal sinuses with the goal of minimizing complications and promoting a smooth recovery process.
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Pilonidal Cyst Treatment
A pilonidal cyst is also known as a pilonidal sinus and the growth may begin as a minor skin irritation near your sacrum. A bump over the tailbone near the buttocks is the most prominent physical symptom of pilonidal disease. A pilonidal sinus typically forms after hair follicles have been pushed back into the skin, causing a localized infection. Treatment for the disease will vary depending on the severity of a pilonidal sinus. For symptomatic relief, a cyst may be drained under local anesthesia.
The Benefits of Minimally Invasive Surgery
To prevent the recurrence of pilonidal cysts, surgery is necessary to remove diseased skin tissue. In the past, surgery has been quite invasive, but Dr. Kamrava advocates the rhomboid flap technique to remove infected skin with a specific type of excision. He then replaces the wound with a healthy flap of skin from a nearby area of the body. The highly effective procedure closes the wound to decrease your chances of getting an infection. You’ll be able to return home the same day as your surgery and get back to normal activities at an accelerated rate.Rhomboid Flap Technique for a Pilonidal Cyst Frequently Asked Questions
Once you’re aware that surgery is the most appropriate solution to treat the diseased skin that causes pilonidal sinuses, you may have a number of questions. Here are answers to common inquiries about the rhomboid flap technique for a pilonidal cyst. If you have additional questions, please feel free to contact Dr. Kamrava at 424.279.8222.Q: What is a pilonidal sinus?
A: A pilonidal sinus appears as a growth on the lowest part of your back—your sacrum—that is near your tailbone. The bump will be filled with fluid, and if it becomes infected, you may experience pain, swelling, redness, or a fever.Q: What causes pilonidal disease?
A: The exact cause of pilonidal cysts is unclear. The condition became widely known during World War II when military truck drivers developed painful, abnormal skin lesions near their tailbones. Today, sitting for long periods of time or trauma to the area may also cause pilonidal disease. Excess hair may also contribute to the formation of a pilonidal sinus.Q: Can pilonidal disease be treated without surgery?
A: When a pilonidal sinus becomes infected, a doctor needs to drain the infection. An incision that drains fluid from the sinus can be performed under local anesthesia in the doctor’s office, but it only provides relief from irritating symptoms. The diseased skin that causes pilonidal sinuses must be extricated with surgery.Q: Is the rhomboid flap technique painful?
A: Excision of diseased skin with the rhomboid flap technique is performed under general aesthesia. You will not have an open wound to care for daily as you would with traditional surgeries, so your recovery period will be shorter and less painful.Q: How long is the recovery process?
A: In order to facilitate a fast and safe recovery, Dr. Kamrava makes a rhomboid-shaped excision to remove the infection, which does not leave an open wound that is difficult to heal; the wound is replaced with nearby healthy skin, and the healing process is much more comfortable than older forms of surgery that required an open wound to heal over the course of six weeks to several months.Schedule a Rhomboid Flap Technique Consultation With Dr. Kamrava Today
As you explore your treatment options for a pilonidal cyst, the rhomboid flap technique utilized by Dr. Kamrava stands out as a superior option. To learn more, please contact our office to schedule a consultation. Dr. Kamrava is an experienced, board-certified surgeon who specializes in highly advanced surgical techniques that treat pilonidal sinuses. Call 424.279.8222 today! Next, learn about fecal transplants. [cta-one]How it's done
- 1Under general anesthesia in the operating room.
- 2The diseased tissue is removed as a diamond-shaped (rhomboid) block, down to healthy tissue.
- 3A matching flap of nearby healthy skin, with its blood supply, is rotated over to fill the gap.
- 4This flattens the cleft and moves the healed wound line off the midline — the spot where pilonidal disease starts — so there is no open wound to pack.
- 5The wound is closed with stitches; sometimes a small drain is left in for the first days. Most people go home the same day or after one night.
What to expect
First days
Soreness at the site — pain medicine is usually needed at first. Keep direct pressure off the area; short walks are encouraged.
First couple of weeks
Wound checks in the office; any drain and stitches are removed. Avoid long stretches of sitting directly on the site.
Several weeks
Gradual return to normal activity as the flap heals. Strenuous exercise and sport wait until the wound has fully settled.
Follow-up
Visits to confirm the flap has healed and stayed flat.
Sources
- Steele SR, Hull TL, Hyman N, et al., eds. The ASCRS (American Society of Colon & Rectal Surgeons) Textbook of Colon and Rectal Surgery. 4th ed. Springer; 2022.
- Johnson EK, Vogel JD, Cowan ML, Feingold DL. The American Society of Colon and Rectal Surgeons' Clinical Practice Guidelines for the Management of Pilonidal Disease. Diseases of the Colon & Rectum. 2019;62(2):146–157.
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