Fish skin is a superior acellular dermal matrix for the treatment of Pilonidal cyst

Introduction: Pilonidal cysts (PCs), cysts that develop in the sacrococcygeal region, are common and frequently impact healthy young males. PCs  is an unusual pocket in the skin that usually contains hair and skin debris.  A pilonidal cyst is almost always near the tailbone at the top of the buttocks. Treatment options range from phenol injections, simple excision and drainage, excision and unroofing with healing from secondary intention, and excision and drainage with primary closure. Fish skin graft (FSG) is a unique biologic scaffold. FSG is rich in Omega3  anti-inflammatory, promotes cellular ingrowth, neovascularization and aids tissue infill and remodel. We hypothesize that FSG, can be used as part of the surgical intervention for pilonidal cysts treatment aiding in tissue formation, vascularization and cellular ingrowth.Methods:A pilot study of 8 patients with  pilonidal cysts were treated by Dr. Michael Romberg. Elliptical excision made and defect is excised in total removing the entire sinus tract. Fenestrated FSG was placed at the base of the wound and closed primarily in several layers.Results:Complete healing  achieved. One time application of FSG led to successful healing time. Patients noticed significant scar reduction. Patients experienced no pain.Discussion: FSG is an effective alternative to conventional surgical intervention of pilonidal cysts. The use of FSG is safe, prevents seroma formation, induces decreased inflammation and scarring, rapid cell ingrowth and neovascularization, low immunogenicity and bacteriostatic properties. FSG is a promising option for treating PCs because of rapid healing with reduced infection rates.References: