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Dr. Kamrava: One of the treatments I have special training in is Pilonidal disease.
Pilonidal disease really came to the forefront during World War II when 79,000 soldiers were
afflicted with it. It was known as 'the jeep driver's disease' and the reason is that a
lot of jeep drivers were getting it. What we found was that the hair at the bottom
of basically, the back at the gluteal cleft was impacting into the skin and causing this
chronic infection that would come and go, come and go every few months.
It's a nest of hair that forms basically in the gluteal cleft. The original treatment
for this was a full excision down to the sacrum and then closure. The difficulty they had
with this at the time was that 50% of these wounds would fail. The average stay in the
hospital was 55 days. Most surgeons now that don't have particular
specialized training in the treatment of Pilonidal disease are treating patients with an open
wound technique; they allow people to go home and for this to heal anywhere from 6 to 21
weeks on average. We've come a long way since then. Now, we're
able to get patients home the same day with a closed wound that has a failure rate of
less than 5 percent. What we're doing is utilizing a flap of healthy
native tissue from the buttocks to close the defect, which takes tension off the wound
and allows for that the closed wound you go home with does not require dressing changes
over a long period. The result in this in the most recent investigations -- and there
have been several -- have demonstrated a recurrence rate of less than 4 percent, and a wound failure
rate that with wound infections is less than 7 percent.
These are the best results we can offer with all the procedures available in terms of a
flap and closed wound for the treatment of Pilonidal disease. We've been able to successfully
use this in our practice to treat countless patients, the results have been promising
and our patients have all been very happy.