John U Bascom

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Pilonidal disease is treated by follicle removal and lateral drainage. The method is suited to outpatient management and gives minimal disability and good long-term control. Other treatment methods for management of the unhealed midline pilonidal incision are discussed. Results are satisfactory to as long as nine years on follow-up. Microphotographs(More)
HYPOTHESIS Refractory pilonidal disease is due to damage of the epidermis in the deep gluteal cleft by moisture and bacteria, rather than to damage in deep tissues. A new paradigm suggests that a procedure to change the shape of the gluteal cleft will improve results. DESIGN Before-and-after trial. SETTING Community private practice with extensive(More)
Contrary to current concepts, shafts of hairs apparently are not the source of most pilonidal disease. Instead, follicles of hairs seem to be the source. Pilonidal disease progresses through five stages. Accumulation of hair within a chronic pilonidal abscess is a late and secondary phenomenon. The acute abscess is drained only. Over the chronic abscess the(More)
BACKGROUND Refractory pilonidal disease is a problem. We wished to show the utility of the cleft lift procedure in solving nonhealing. METHODS We selected a subset of challenging cases for this study. The subset included all patients referred with persistent open wounds despite at least 2 prior pilonidal surgeries elsewhere. RESULTS The 69 patients had(More)
Radical excision of pilonidal disease is unwarranted. The unhealed wound which may follow such surgery can be salvaged by the technique of cleft closure. Should repeat operation become necessary, the technique of cleft closure should be performed. It is simple, causes little disability, results in primary wound healing, and requires minimal postoperative(More)