Obliteration of dead space created by block excision of a sacrococcygeal cyst or sinus offers a challenge to the skill of the surgeon attempting a primary closure. Many ingenious techniques have been devised to close this dead space,* as it is the key to primary healing.
The problem of wound healing in the sacrococcygeal region is complex, and infection frequently nullifies the results of the most meticulously performed surgical procedure. The presence of numerous sweat glands and hair follicles makes preliminary sterilization of the skin almost impossible, and late contamination of the wound is a hazard because of excess perspiration and the proximity of the anus. Tissue trauma produced in mobilizing flaps tends to promote the exudation of fluid, and the sacral fascia offers a poor absorptive surface, allowing the accumulation of fluid and blood, which is a perfect culture medium for any bacteria that gain entrance into the wound.
GORDON M. CARVER. Sacrococcygeal Cysts and SinusesUse of Elastic Pressure Dressing to Obliterate Dead Space and Facilitate Primary Healing. AMA Arch Surg. 1955;70(4):555–558. doi:10.1001/archsurg.1955.01270100081013