Our non-surgical treatments for 
Pilonidal cyst

Often, after initial healing, the wounds suddenly stop closing. Therefore, bleeding and discomfort occur again and again. Often, in this situation, a new elimination is recommended, followed by a new wound healing phase. 
We always try to avoid this and offer painless, non-surgical methods, which in many cases lead to a safe closure of the wound.

Shock wave therapy for the pilonidal cyst

In addition to the established indications in orthopedics such as the treatment of heel spurs, tennis elbow or the healing of bone fractures, the shock wave also supports wound healing in chronic wounds or burns.
 In this context, the shock wave represents a new therapeutic option, particularly in the case of delayed wound healing after major sinus pilonidal surgery. 

Which wounds are suitable?

  • Non-healing wounds such as the pilonidal cyst
  • Diabetic gangrene 
  • Ulcus cruris (diabetic)
  • Ulcer (non-diabetic) 
  • Skin burns 
  • Scars

Treatment advantages

  • Non-invasive therapy
  • Hardly any side effects 
  • No local anesthesia (injections)
  • Outpatient treatment 
  • Long lasting effects 
  • Short therapy times (8-10 minutes)

How does a shock wave work?

The process of electromagnetic shock wave generation is based on the physical principle of electromagnetic induction, as used in loudspeakers, for example. The arrangement of coil and diaphragm is optimized in such a way that particularly powerful and short acoustic pulses are generated. 
 
Originally, these pulses were used in the early 1980s to break up kidney stones, a procedure known as "extracorporeal shock wave therapy" (ESWT).  
 
In the last 20 years, there has also been a wider therapeutic use in orthopedics, where there is now a wide range of indications for the treatment of musculoskeletal diseases. Here, the costs are also partly covered by the statutory health insurers. 

What does a shock wave do in the body?

Treatment with low-energy shock waves leads to blood flow stimulation and also stimulates the formation of new capillary vessels (angiogenesis) through the release of growth factors, which allows the tissue to proliferate and ultimately leads to closure of the defect. 
 
At the same time, a constant energy level and the large focal zone guarantee safe treatment of the wound. 

What is the process of treatment with the shock wave in sinus pilonidalis?

In the focused shock wave, the patient lies on the abdomen in the case of a non-healing pilonidal sinus. The transducer is held on the wound area and the shock waves are delivered continuously at 50-100 pulses / cm2. The treatment lasts about 8-10 minutes. As a rule, the procedure is not painful.

For therapy success, at least 6 sessions should be arranged. After that there is a break with a therapy control after about 3 weeks. After that, further sessions can be done if necessary. The cost for 6 treatments is about 400 €.

Important: Unfortunately, shock wave therapy is not covered by statutory health insurance. Therefore, if you would like this therapy, we will be happy to provide you with a cost estimate as an IGeL service (according to the German Fee Schedule for Physicians, GOÄ).
Private patients please inquire with your insurance company about cost coverage prior to treatment. 

 
Caution: Treatment should not be performed in patients with tumor disease, pregnancy and therapy with Marcumar or similar blood thinners. 

Initial findings

The wound is about 4cm long and 2cm deep. The wound tissue is soft and there is no solid structure. The wound is very sensitive and bleeding occurs quickly.

After 2 weeks treatment

The wound begins to heal from the depth and the length is only 3cm. Bleeding has been rare.

After 4 weeks treatment

The wound is healed in depth and superficially there is still a defect of 1.5cm. 

- Shockwave therapy has analgesic and anti-inflammatory effects and promotes wound healing through collagen formation -

Platelet Rich Plasma

Our blood consists of water, white and red blood cells, and platelets.

In PRP (Platelet Rich Plasma) therapy, a protein-rich concentrate is extracted from the blood platelets and injected into the corresponding part of the body using a special syringe. 
 
Platelets contain numerous growth factors and cell messengers (cytokines) that serve cell renewal, which gives PRP treatment its regenerative potential and stimulates the adjacent tissue to grow.

Where can PRP therapy be used?

Indications for autohemotherapy are especially orthopedic clinical pictures such as joint diseases (arthroses), tendonitis and accelerated treatment of bone fractures. These treatments have been practiced for years and are widely established.
In addition, autohaemotherapy is increasingly used in the treatment of chronic wound healing disorders or as an anti-aging therapy in aesthetic medicine. 
A great advantage is due to the body's own tissue that there are no side effects in the sense of allergic reactions or inflammations.

Important: Unfortunately, Platelet Rich Plasma (PRP) therapy is not covered by statutory health insurance. Therefore, if you would like to have this therapy, we will be happy to provide you with a cost estimate as an IGeL service (according to the German Fee Schedule for Physicians, GOÄ). Private patients please inquire with your insurance company about cost coverage prior to treatment.

Treatment should not be performed in patients with tumor disease, pregnancy and therapy with Marcumar or similar blood thinners. 

PRP for which wounds?

  • Non-healing wounds such as pilonidal sinus
  • Anal fistulas
  • Ulcus cruris (diabetic)
  • Ulcer (non-diabetic) 
  • Skin burns 
  • Scars

Treatment advantages

  • Hardly any side effects, since the patient's own blood is free of additives
  • No local anesthesia
  • Outpatient treatment 
  • Long lasting effects 
  • Short therapy times (10 minutes)

How does the treatment proceed?

After blood collection, the so-called whole blood is immediately placed in a special tube in a centrifuge. No further processing is necessary. The centrifugal force separates the blood into three components. This happens because of the different specific gravity.
 
The uppermost part consists of the part poor in blood cells and platelets, the plasma, which makes up about 55%. In the middle, white blood cells (leukocytes) and platelets (thrombocytes) accumulate with about 4% of the total volume. The lowest layer consists of red blood cells (erythrocytes), which clump together to form a blood cake and make up about 41%.  
 
The platelet-rich plasma is drawn from the tubes and injected into the patient's body site to be treated, whereby the added growth factors induce tissue growth and improve healing.  

- PRP therapy is a useful attempt to stimulate wound healing when other methods are not effective - but it cannot perform miracles -