This approach is especially useful for complicated or recurring pilonidal disease, leaves little scar tissue and flattens the region between the buttocks, reducing the risk of recurrence. This approach typically results in a more rapid recovery than the traditional surgery, however there are fewer surgeons trained in the cleft lift procedure and it consequently may not be as accessible to patients, depending on their location. Meta-analysis shows recurrence rates were lower in open healing than with primary closure (RR 0.60, 95% CI 0.42 to 0.87), at the expense of healing time. Pilonidal cysts can recur, and do so more frequently if the surgical wound is sutured in the midline, as opposed to away from the midline, which obliterates the natal cleft and removes the focus of shearing stress. An incision lateral to the intergluteal cleft is therefore preferred, especially given the poor healing of midline incisions in this region. Minimally invasive techniques with no wound and rapid return to full activities have been reported but await double blind randomised trials.Another technique is to treat pilonidal sinus with fibrin glue. This technique is of unclear benefit as of 2017 due to insufficient research. The evidence for any treatment is of low quality, and care must be taken not to over interpret any study in this field.In some cases wounds are left open after surgery to heal naturally instead of being closed with stiches. There are a lot of different dressings and topical agents (creams or lotions) that are available for helping these open wounds to heal.
A 2022 systematic review brought together evidence from 11 studies that compared dressings and topical agents for treating open wounds after surgical treatment for pilonidal sinus of the buttocks. The authors concluded that: platelet rich plasma may help wounds to heal quicker compared to sterile gauze; Lietofax skin repair cream may help wounds to heal by 30 days compared to iodine (which helps to reduce bacteria in the wound); but it is not clear whether hydrogel dressings (designed to keep the wound moist) reduce the time it takes wounds to heal compared with cleaning the wound with iodine. Etymology
Pilonidal means nest of hair and is derived from the Latin words for hair (pilus) and nest (nidus). The condition was first described by Herbert Mayo in 1833. R.M. Hodges was the first to use the phrase pilonidal cyst to describe the condition in 1880.The condition was widespread in the United States Army during World War II. The condition was termed "Jeep seat" or "Jeep riders disease", because a large portion of people who were being hospitalized for it rode in Jeeps, and prolonged rides in the bumpy vehicles were believed to have caused the condition due to irritation and pressure on the coccyx. References
External links

NHS Choices for pilonidal sinus treatment