# A Case Report of Wound-Vacuum-Assisted Closure (VAC) Treatment Following Pilonidal Cyst Excision

## TL;DR

A 28-year-old man with a recurring pilonidal cyst was successfully treated with wound-VAC after surgery, leading to effective healing.

## Contribution

This case report highlights the successful use of wound-VAC in pilonidal cyst excision recovery.

## Key findings

- Wound-VAC facilitated granulation tissue formation and reduced wound size and depth.
- The wound healed via secondary intention with minimal pain and no complications.
- Wound-VAC was removed after two dressing changes, indicating effective initial healing.

## Abstract

Pilonidal cysts are subcutaneous cysts that typically occur in the sacrococcygeal region and are more prevalent in obese, hirsute males. Pilonidal cysts are believed to be caused by a pore that forms as hairs become drawn deeper within the pore, ultimately creating a sinus. Different therapeutic options have been described, including excision with primary closure, healing by secondary intention, or flap creation; however, finding the optimal approach is a work in progress. We report a case of an otherwise healthy 28-year-old man who presented with a recurrent pilonidal cyst with a chronic sinus tract despite previous repeat incision and drainage procedures. The patient underwent pilonidal cyst excision with vacuum-assisted wound closure (wound-VAC) placement to facilitate the healing process. After two changes of the wound-VAC dressing (postoperative day eight), fresh granulations formed. The wound size and the wound depth decreased, requiring no further need for wound-VAC dressing. Over the next three weeks, the wound healed via secondary intention with a simple dry-to-dry gauze dressing with minimal intermittent pain and without any complications.