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Colorectal Diseases

Pilonidal cysts

02/26/2007

Question:

How are pilonidal cysts lanced to relieve the pus? Is anesthesia commonly used before this procedure?

Answer:

If a patient is able to tolerate drainage of any abscess in an out-patient setting, the physician may choose to use "local anesthesia" placed into the skin through a needle, or applied topically as a cream, or both. This numbs the skin in the spot where the incision is made to drain the pus, but does not anesthetize the surrounding tissues in most cases. Unfortunately, reddened infected tissue is very difficult to numb up, because of it's acidic pH- so "local anesthesia" is not always completely effective.

Occasionally a large abscess will need to be drained after the patient is sedated. This may be done in a monitored setting, like an emergency room or procedure room, or in an operating room. Relieving the pressure created by the pocket of pus leads to great relief immediately, making it an important and worthwhile procedure.

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Response by:

University of Cincinnati Janice Frederick Rafferty, MD
Associate Professor, Chief
Division of Colorectal Surgery
Department of Surgery
College of Medicine
University of Cincinnati
Janice Frederick Rafferty, MD