Marsupialization
Marsupialization is yet another well-known treatment option for pilonidal cysts. First introduced in 1937, marsupialization is a compromise between wound closure and open wound packing. With marsupialization, the doctor uses local anesthesia, consisting of one percent lidocaine and epinephrine. Then, the doctor makes a shallow cut on the sac and unroofs it. The doctor drains the pus and fluid and removes the hair in the sac. Then the overhanging skin is excised, and the wound edges are grasped with an Allis forceps and sewn together, creating a pouch.
This outpatient surgery treatment for a pilonidal cyst will help avoid wound infection and dehiscence, allowing for minimal postoperative morbidity. Because the cuts are shallower, there is no need to take out and repack the gauze daily, unlike the treatment option that leaves open incision sites. As far as recovery is concerned, marsupialization allows for shorter healing time compared to open-wounded incision and drainage, though it would still take approximately six weeks to heal. Plus, it will require an especially trained doctor to conduct the operation.
