THE CLEFT-LIFT PROCEDURE

The gold standard for definitive surgical treatment of recurrent pilonidal disease and nonhealing wounds following previous surgery is the Cleft Lift surgery, also known as the Bascom Flap repair.

The cleft-lift procedure is a specialized surgical technique used to treat pilonidal disease, particularly in cases that are recurrent or resistant to other treatments. This procedure is designed to address the underlying issues of pilonidal disease by removing the affected tissue and reconstructing the area to prevent future complications.

During the cleft-lift procedure, the surgeon makes an incision along the upper aspect of the buttock crease, carefully excising the pilonidal disease tissue, including any sinus tracts and abscesses. The procedure involves lifting and repositioning the skin flaps to close the defect and reduce the depth of the natal cleft, which is the area prone to pilonidal disease. This repositioning helps to create a more superficial and less prone-to-infection area. The edges of the incision are then sutured together to promote proper healing and minimize the risk of recurrence.

The cleft-lift technique is known for its effectiveness in reducing the likelihood of pilonidal disease returning, as it addresses the primary factors contributing to the condition. It also helps to alleviate discomfort and improve the overall function and appearance of the affected area. 

At Pilonidal Fix, we perform the cleft-lift procedure at our ambulatory care center under general anesthesia, with the surgery lasting approximately 90 minutes. Following the procedure, the wound is closed with multiple layers of absorbable sutures and a small drain is placed. Patients are advised to rest at home for 48 hours post-surgery. The drain is usually removed about a week later, either by a family member or friend at home, or during a follow-up visit to our center. 

To ensure proper healing, stress on the operative site should be avoided for three weeks. Full recovery is typically achieved within six weeks.