My story started 25 years ago when I was 18 and a senior in high school. The messy underwear, itchy and smelly pain led me to a colo-rectal surgeon who diagnosed it. He immediately recommended excision with open wound healing. I had no knowledge of pilonidal, nor did my parents. So, looking back, after ingoring it for so long, that 1st cyst was the size of a raquetball. The approach to open wound healing for me at the time for was 2 baths per day, douse the thing in betadine, and pack w dry gauze. The healing succeeded to about 80-90% after 6 months. At which time he gave me silver nitrate sticks – burned like a mother. Sophomore year of undergrad, I was having same symptoms and turned out a recurrence of a cyst on the same incision line from 1st procedure. This time, they do the Z-plasty and find 2 cysts. They remove both and also remove other visible holes. Recovery from the Z-plasty was awful. 4 years after that, I had another recurrence, along part of the Z-plasty line. Removed, open wound, fairly small. All was quiet until 2 weeks ago. 2 weeks ago, as a 44 year old male, I had my 4th cyst removed. But this was the 1st time any surgeon has ever closed 1 of mine – except the z-plasty. Going into the surgery, the colorectal surgeon remarks “this should be no big deal. very small, cut it out, then sew it up.” I questioned him on sewing it up. I have been blessed with lots of hair, lots of scarring, complicated butt region, shouldnt you leave it open doc? Nope. Sews it up. Procedure on Wednesday. Friday I am running a fever and am in the worst PC pain I have ever had. Friday night, I go to acute care and they send me to the hospital for immediate excision and drain. After 2am surgery the on-call surgeon asks me “why the hell did the surgeon close that?” I now feel like I am 18 again (HA!) and dealing with this god-awful open wound for next 6-8 weeks. The allegedly “small cyst” has left a 10cm x 6 cm deep x 2 cm wide hole. I am glad to read about the new open wound dressings available. My surgeon is using a Matristem application down in the wound to speed healing. I am also going to a Wound Care center to try to shorten this 6-8 weeks, but also eliminate all possibility that this happens again. To all the literature about “rarely happens to males above 30″….um, you’re wrong. Agree with other story-posters: this site has been great. Thank you.