The gluteal cleft is just above the anus. 0 cm at D/C Gluteal cleft: Resolved in 11 d R buttock: Blanching erythema in 11 d/completely resolved in 20 d Ischial tuberosity medial: resolved in 11 d Ischial tuberosity lateral: Resolved in 11 d: 3: R gluteal cleft stage 2: 3: R buttocks DTI: 3 The vertical line starts from sacrum to the perineum. Some of my most grateful patients were referred from a wound clinic for a cleft-lift which proved to be successful. application into the gluteal cleft. Moderate Erythema (redness), with less than 50% broken skin. The gluteal cleft and the gluteal fold both occur normally in humans. 820A. Nevertheless, accurate classification of these lesions is frequently challenging, even for experienced wound clinicians. 2. The wound was primarily closed and the patient had an uneventful post-operative course with no recurrence of her cyst to date. This is the American ICD-10-CM version of M25. It is currently hypothesized to be an acquired condition with local penetration of hair follicles and debris in stretched intergluteal pores. A step-by-step drawing of the surgical process. 829A: Unspecified open wound of left buttock, initial encounter. May be ‘copy’, ‘mirror’ or ’kissing’ lesion on adjacent buttock or anal-cleft. . 00 [convert to ICD-9-CM] Gluteal tendinitis, unspecified hip. Main Outcome Measures Number healed, time to healing, number of operations required. 3 × 0. 312 - other international versions of ICD-10 L89. 18 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Pilonidal surgery is a minor procedure typically performed by a colorectal surgeon who removes the cyst and any surrounding infection. However, the opening of the fistula tract may be present in the left costal margin, right iliac fossa, right groin, or right gluteal region. Then, the surgical wound is closed by rotating other tissue to cover the area. on the WOCN Society's wound care forum and to an e-mail sent to members of the WOCN Iowa Affiliate. The coccyx, often referred to as the ‘tailbone,’ sits at the very tip (or inferior end) of the spinal column. Damage may be focused on the dependent area of the wound in extremities, due to pooling of wound exudate. If the wound. On examination, she was afebrile, and her pulse was 115 beats per minute. gluteal cleft with associated midline pits. Colorectal Dis. A butt rash can have several causes. On day 14, he was extubated. Left untreated, the periwound will eventually break down and the wound will. Applicable To. These. L03. 303 may differ. 91 may differ. painstaking wound care is feasible. This means that the butt crack will appear off-center. A suction drain was inserted and left for four to seven days till there was no or minimal drainage except if signs of inflammation were evident. (C) The wound after 6 weeks. The gluteal cleft is a common area for wound difficulties, and potential bacterial contamination, as well as persistent underlying seroma (common at two weeks post-op) can make this more than a superficial wound healing concern. A pilonidal cyst is a cyst or abscess (boil) located near the intergluteal cleft, otherwise known as the groove between the buttocks. Moisture-associated skin damage (MASD) occurs with exposure to various sources of moisture (bodily secretions or effluents) such as urine or fecal matter, perspiration, wound exudate, mucus, digestive secretions, respiratory secretions, or saliva. Pressure ulcer with full thickness skin loss involving damage or necrosis of subcutaneous. . Keep an eye on the wound area daily for any type of changes in skin condition. Symptoms of IAD include: redness, ranging from light pink to dark red, depending on skin tone. The condition, which has an annual. 5 × 1. ”. Cutaneous abscess of gluteal region. rianal and gluteal cleft from exposure to stool. After drainage of the gluteal abscess, the patient re-presented with faecal loss from the abscess drainage site. BACKGROUND. Pilonidal cysts are a common condition, with more than 70,000 cases reported in the U. S31. This lady left me much improvedat the end of three ^months treatment. [161, 162] The gluteal thigh rotation flap is an axial flap based on the inferior gluteal artery. 4. Wound cleansed with NS and 4x4's, then the periwound was prepped with 3m no sting barrier and adhesive drape, with stoma paste to inferior gluteal cleft for occlusive seal. Wide surgical excision is the treatment of choice and leads to cure. The documentation states "incision into the skin. 80 Open wound of unspecified buttock. This study was designed to determine the level of agreement among wound care nurses when asked to classify the etiology of 9 wounds located on the buttocks and within the intergluteal cleft. Intergluteal cleft. Bone cultures grew Morganella morganii with pathology consistent with acute osteomyelitis. 0):. S31. The 2024 edition of ICD-10-CM S31. Excision: removal of the involved area. 1 Depending upon the skin areas exposed to urine or stool and/or the use of containment devices, IAD can also extend to the inner and posterior thighs and may include other ele-ments such as candidiasis (Figures 1 and 2). include the gluteal cleft, coccyx, perineum, buttocks, groin, face, hands, feet and other areas. The other synonyms of gluteal cleft are anal cleft, gluteal sulcus, natal cleft and intergluteal cleft. Failure of the procedure was defined as lack of complete healing or recurrent pilonidal disease requiring revisional surgery. An incision 1/2″-3/4″ is best. Problems with the gluteal cleft are very common. mbort True Blue. A pilonidal cyst (intergluteal pilonidal disease) is a skin condition caused by local inflammation of the superior midline gluteal cleft, which may progress to a local abscess or fistula. This topic provides a practical framework for clinicians on how to differentiate Stage 2 pressure ulcers/injuries on the gluteal region from selected common conditions, namely incontinence-associated dermatitis (IAD) and f riction-induced skin injury (FISI), including pictures and ICD-10 codes for these conditions. Turned our attention to the areas of drainage on the bilateral gluteal cleft, these areas were opened. The wound exam showed a partial-thickness wound just above the cleft of his buttocks roughly 1. 1,4 However, some believe all gluteal cleft anomalies other than dimples warrant. Location-in skin folds, gluteal cleft, or the perianal area Shape-diffuse superficial spots, narrow linear breaks in the skin, and “kissing lesions” (on both sides of the buttocks Depth-superficial, partial thickness Necrosis-none Margins-can be irregular with pink or white macerated edges Color-pink to red base The management of recurrent pilonidal sinus is intended to reduce intergluteal cleft depth and reduce friction or gluteal motion in the process. After injecting with 0. We have performed over 2 dozen cases using this technique, and all of our. Catherine R. Healing pressure ulcer of right buttock, stage 2. L02. A person with a pilonidal cyst may experience swelling, pain, and skin discoloration in the affected. On day 6, gluteal erythema was noted, and the wound care team recommended topical medication, attributing erythema to occlusion and moisture. 2 × 1. 829A is an initial encounter code, includes a 7th. Approximate Synonyms. The 2024 edition of ICD-10-CM S31. 829) S31. Synonyms: absent navel syndrome, acquired disorder of. 819A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 1% (79 of 219), and perineum in 3. L30. Inflamed, swollen skin. A pilonidal cyst (intergluteal pilonidal disease) is a skin condition caused by local inflammation of the superior midline gluteal cleft, which may progress to a local abscess or fistula. This is the American ICD-10-CM version of L30. At her 2 week follow-up appointment, the left natal cleft wound had not healed and a sinus developed over the surgical site with recurrent discharge and tenderness. 0±8. Without. is the umbrella organization of German-speaking wound treatment societies. The gluteus maximus muscle is a broad, thick, quadrangular muscle that forms the prominence of the buttocks. The gluteal cleft is again examined, and all sinuses probed with a blunt instrument to determine the depth and direction of the underlying tracts. Open wound of cheek; ICD-10-CM S01. 31 became effective on October 1, 2023. Carefully examining the gluteal cleft on a regular basis and palpating the area to assess for pain and bogginess is important. Unspecified open wound of right buttock. Clinical case series: Using a hydrophilic wound dressing for autolytic debridement. difficult-to-dress wounds with light-to-moderate exudate such as those near the gluteal cleft. Puncture wound of left ankle; ICD-10-CM S91. There are a number of useful strategies to keep in mind when answering multiple-choice tests. of gluteal cleft wounds. 9 cm peripherally enhancing, partially septated cystic lesion at the superior aspect of the right gluteal cleft without signs of spinal canal dysraphism or tract to. The characteristics of a good drainage procedure are: It is drained early, so it hasn’t become too large. She. (See 'Treatment of erysipelas' above. The prevalence of IAD varies widely depending upon the setting. Stage 2- The 3 P's! Pink, Partial, Painful! Stage 2 wounds are partial thickness and often resemble a very shallow ulcer with a reddish-pink wound bed. Two phlegmon were removed last visit from the superior medial aspect of the gluteal muscle at the gluteal cleft. Dr. Figure 3. The inferior two wounds located on the upper inner thigh adjacent to, but not including the scrotum are now open. it is important to identify the cause of lesions as the treatment and management of pressure ulcers and moisture lesions differ. 2 cm. Remove the tibia and fibula. 6). Intertrigo is due to genetic and environmental factors. Linear SevereCare was taken to place the first limb in the gluteal cleft and along the gluteal fold, mirrored by the opposing flap (Figs. S. Clinical features include erythema, edema, vesicles, bullae, and oozing. of gluteal cleft, with dressing ‘base’ positioned to cover coccyx area. (B) Sever all knee ligaments. •Stable (dry, adherent, intact without erythema or fluctuance) eschar on the heels serves as “the body’s naturalGluteal cleft. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks). With the cleft lift procedure,. Psoriasis can affect the gluteal cleft. Colloquially the intergluteal cleft is known as bum crac…Note the off-midline placement of the incision and decreased depth of the gluteal cleft. A lumbosacral MRI revealing a 2. In the patient's gluteal cleft, about 3 cm away toward the coccyx, there was a perineal wound. 829A - other international versions of ICD-10 S31. The small contralateral decubitus ulcer was treated. There are several disorders that can affect the intergluteal cleft including inverse psoriasis , [2] [3] caudal regression syndrome , [4] and pilonidal disease . 5 Infrequently a patient can be asymptomatic with the lesion discovered on routine examination. In the sacral area, there are several common skin problems that require differential diagnosis, including skin tears, 3 moisture-associated skin damage (MASD), 8,9 gluteal cleft, 10 or friction injuries. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. 7% in the general population, more commonly affecting males (male to female ratio: 4:1) between the ages of 15 and 38 years . This is the procedure we provide at the Evergreen Surgical Pilonidal Clinic, in Eau Claire, Wisconsin. 1 -- S32. [6] Physical exam findings include midline pits in the superior gluteal cleft and may be associated with cephalad or lateral tracking sinuses. Triad facilitates autolytic debridement to help manage necrotic tissue such as slough and eschar. Wounds directly in the midline of cleft are the hardest to heal due to lack of oxygen. found correlation in depth of the gluteal cleft, measured with a uniquely designed device, and found that those with PD had significantly deeper intergluteal clefts. I know that I do not have an anal fissure or fistula becuase the open sore is located inside my gluteal cleft. Purpose: This study was designed to determine the level of agreement among wound care nurses when asked to classify the etiology of 9 wounds located on the buttocks and within the intergluteal cleft. Nurses should have knowledge of the types of dressings that are appropriate for pilonidal wounds. 000S - Unspecified open wound of lower back and pelvis without penetration into retroperitoneum [sequela] A pilonidal cyst is a cyst or abscess (boil) located near the intergluteal cleft, otherwise known as the groove between the buttocks. Codes mentioned in articles are linked to Code Information pages. After excision of diseased tissue, plastics entered to evaluate the tissue. Gluteal cleft (often see moisture damage rather than pressure damage in this area) Perianal / perineal area (often due to moisture eg. 829S. (71 g) 12 1967 6 oz. The aim of this article was to summarize results of the consensus sessions that occurred. 5. Intertriginous skin, also known as skin folds, are sites in which opposing skin surfaces come into contact while at rest, resulting in chronic skin occlusion. Symptoms of intertrigo. She previously was diagnosed by her periodontist with erosive lichen planus and was prescribed topical and oral steroids with minimal improvement. Approximately 70%-90% of pressure injuries are superficial and heal by second intention. The flaps require good preoperative planning and design. 313 - other international versions of ICD-10 L89. The most commonly reported symptoms include pain, dyspareunia, pruritus, and discharge. Adequate débridement of necrotic and devitalized tissue. These wounds come apart because they are down in the gluteal cleft, and because of the location, they do not heal. One piece of small white foam was cut into a rectangular shape and fitted into the undermining at 10 o'clock only per Jane Smith, PA who is present at bedside during assessment. and basic treatment of the wound may be performed by a primary care provider. 91 became effective on October 1, 2023. The gluteal sulcus is formed by the posterior horizontal skin crease of the hip joint and. Recently, my cleft area became red, inflamed, and. Wound appears to be relatively clean, with only trace erythema around the periphery of the wound. 317 may differ. If the area of recurrence is relatively small with a shallow intergluteal cleft, open the tracts. The rotating of tissue causes the gluteal cleft to shift. As they fall apart, bacteria begin growing in the wound, and it appears as if infection caused the incision to separate – but actually it is the opposite. 1. Pilonidal cysts tend to occur on a person’s lower back, just above the cleft of the buttocks. 3 Loose hairs trapped in the natal cleft traumatize and penetrate the skin, creating a foreign body reaction that may ultimately lead to formation of midline pits and, in some cases, secondary infection. for difficult-to-dress wounds with light-to-moderate exudate such as those near the gluteal cleft. 409A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Patient has recurrence of pilonidal disease. 2). Pain. Excludes2: abscess of anus and rectal regions (K61. A holistic wound assessment should include a full review of systemic, psychosocial,and local factors thatICD-10-CM Diagnosis Codes. After skin is prepared, remove the centre. Pilonidal disease is an acute or chronic infection in the subcutaneous fatty tissue, mainly in the natal (intergluteal) cleft. Oral options include penicillin V potassium, amoxicillin, cephalexin, and cefadroxil. 0):. 8 - other international versions of ICD-10 Q82. Excludes1: traumatic amputation of part of abdomen, lower back and pelvis ( S38. For more information, call 800 -840-9041or visit our website at Documenting Wounds (Part 2 - Anatomic Location) Consistency in wound documentation is of utmost. A finger sweep was conducted that showed the subcu tissue. The 2024 edition of ICD-10-CM L02. Browse Getty Images' premium collection of high-quality, authentic Gluteal Cleft stock photos, royalty-free images, and pictures. Common symptoms are a painful lump, bleeding, drainage, or enlarged pores in the midline of the gluteal cleft. One patient shares their personal tips for relief. Many people think of pilonidal disease (PD) in its acute presentation, which is an abscess at the gluteal cleft that is warm and tender with purulent drainage. rapid heartbeat. 0 cm at D/C Gluteal cleft: Resolved in 11 d R buttock: Blanching erythema in. Pilonidal disease is a reaction to hair in the gluteal cleft, in which unattached hairs injure or pierce the skin, resulting in a foreign body reaction. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus. Polyglactin 0 sutures were used to approximate both gluteus muscles and fasciae together covering the inter-gluteal cleft. The official AHA publication for ICD-10-CM and ICD-10-PCS coding guidelines and advice. negative pressure wound therapy, readvancement, and secondary closure, which resulted in a standing cone/dog-ear deformity. Figure 3. The term pilonidal cyst comes from the Latin words, “pilus” (hair) and “nidus” (nest). Keep in mind not to use soap. b 14 days after surgery, 12 × 8 cm skin necrosis, prowl separation area approximately 85 × 65 cm, the purulent exudate in the space, and the original fixed anus shortened (the arrow shows. The 2024 edition of ICD-10-CM L98. Gunshot wounds are one of the most common causes of spinal cord injuries. 0 cm at D/C. A 55-year-old woman with CD and HS was referred to a dermatology clinic in July 2015 for evaluation of a peristomal rash. Another advantage of the GT-flap over other options is the symmetrical midline scarring, thereby preserving the gluteal cleft and restoring normal perineal aesthetics (Fig. S31. Two pilonidal cysts that have formed in the gluteal cleft of an adult man. Pilonidal cysts typically manifest as a sinus. (71 g) 12 1967 6 oz. (C) The wound after 6 weeks. This common type of cyst is located in the crease of the buttocks and is usually caused by a skin infection. 1. The veins accompany the arteries and drain. Shape Diffuse often multiple lesions. It can become infected or inflamed, and usually requires surgical excision of the sinus. Other names are the anal cleft, crena analis, crena interglutealis, and rima ani. There are several names for this area: natal cleft, gluteal crease, gluteal crevice. Triad Hydrophilic Wound Dressing Product Code Size Units 1964 2. Moisture from insensible water loss and sweating cannot evaporate due to occlusion. It is commonly seen in the skin between. Not usually over a bony prominence. Hair and other debris from skin or clothing can lodge in the pores. ICD-10-CM Codes. 604 Trauma to the skin, subcutaneous tissue and breast with mcc; 605 Trauma to the skin, subcutaneous tissue and breast without mcc; 963 Other multiple significant. 9 Unspecified fracture of femur. L89. Left untreated, the periwound will eventually break down and the. 1 The latter name, although. Applicable To. 3, 4). These DTI patterns have been seen in patients who have. Histology showed a benign intradermal naevus. Gluteal tendinitis; Gluteal tendonitis. Stage 1- A non blanching red area, that does not go away. Intertrigo is a common inflammatory skin condition that is caused by skin-to-skin friction (rubbing) that is intensified by heat and moisture. Pilonidal disease is a chronic skin infection in the crease of the buttocks near the coccyx (tailbone). Poster presented at: SAWC® Fall; September 23-25, 2010; Las Vegas, NVI need help coding this: The pt was taken to the operating room, placed in right lateral decubitus position and sedation was administered. 1 Given the low incidence rate of OSD at 0. Pressure Ulcer of Gluteal Cleft. CH. 809A - Unspecified open wound of unspecified buttock [initial encounter] ⑩ [Billable] There's more to see -- the rest of this entry is available only to subscribers. The area is prepped with an antiseptic solution and draped in a typical fashion. Intertrigo occurs more easily in environments that are hot and humid. accumulation of dead hairs in the natal cleft, poor wound care, and lack. Sagittal STIR (a) and contrast-enhanced T1-weighted fat-suppressed (b) images show a focal region of STIR hyperintensity along the superior gluteal cleft, in the subcutaneous fat, and overlying the coccyx (arrow), consistent with a pilonidal cyst. 4 may differ. In contrast to reconstruction of a large sacral soft tissue defect, options for reconstruction of a large gluteal soft tissue defect have seldom been discussed in the literature. Main Outcome Measures Number healed, time to healing, number of operations required. Deep natal cleft is an important factor in the pathogenesis of pilonidal sinus disease [ 14 ]. A stage 2 pressure ulcer may appear as a shallow, crater-like wound or a blister containing a clear or yellow fluid. L02. Erythema intertrigo. Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. 9% of cases the wounds were not penetrating and in 6. functions of the skin. An odor from draining pus. 0):. a moisture lesion will not heal if treatedHere are some of the most common symptoms of herpes on the buttocks: skin feels itchy or burns before bumps or blisters appear. Approximate Synonyms. Act as if they’re loaded, even if you’re. Triad adheres to wet skin, and can be used on broken skin in the presence of incontinence, or maceration of the peri-wound skin. Differential assessment of trunk wounds: pressure ulceration versus incontinence-associated dermatitis versus intertriginous dermatitis. The. 032A Puncture wound without foreign body, left hip. Introduction. 3). Gluteal cleft is the vertical partition which separates buttocks. Abstract. This is a major advantage compared to the VRAM or conventional gluteal flaps (e. The gluteal fat is allowed to appose and excess skin is excised to re-contour the natal cleft and allow a shallower closure away from the midline. 810A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Conclusion: According to the available evidence and guidelines, off-midline procedures - the Karydakis flap, Bascom cleft lift, and Limberg flap procedures - are associated with lower recurrence rates and better wound healing. It can vary significantly from one person to another. Definition. Irregular surfaces could include the gluteal cleft, coccyx, perineum, buttocks, groin, face, hands, feet and other areas. 322 - other international versions of ICD-10 L89. 16 min. The 2024 edition of ICD-10-CM L89. 8 Other fracture of femur. Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. ous infection. S71. An asymmetrical ellipse of skin at the right or left side of the gluteal cleft (depending on the location of the pits or sinuses) was marked and, after wide. Triad Hydrophilic Wound Dressing offers a unique approach to wound management and wound treatment. " Buttock is the skin location where the abscess is located. The only way to prevent palpable or visible implants (the major causes of a poor result) is through the intramuscular plane. 3. 5 loose hairs in the natal cleft skin create a foreign body reaction that ul-timately leads to formation of midline pits and, in someGluteal crease, gluteal cleft, buttock cleft, natal cleft: this is the crease between the right and left buttocks. Risk Factors. In this article, we describe how PD is an acute, chronic, and recurring disease that requires clinicians. 0 Traumatic amputation at hip joint. Toward the bottom of your spine, where your buttocks split, is a crease called the gluteal cleft. 4. L02. Both CT and MRI are optimally performed with the patient supine, which can apply pressure to the affected area with subse-quent pain. Computed tomography (CT) with oral and rectal. A deep natal cleft is associated with PSD and should be considered the cause of the condition. Since sudoriferous glands are. 4 When a large amount of tissue is removed, as in traditional pilonidal surgery, and the incision is closed in the midline, the cleft remains deep, a dead space is often created, and this leads to recurrent infection or unhealed wounds. Abstract. 829A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 810A became effective on October 1, 2023. The most common location was the gluteal cleft. 300 is a billable ICD-10 code used to specify a medical diagnosis of pressure ulcer of unspecified buttock, unstageable. After injecting with 0. The cyst can become. The separation allowed bacterial. Oct 16, 2008 #2 you're joking right? ? M. This is the American ICD-10-CM version of L05. sensation -pain,touch,temp,pressure. The recovery from cleft-lift is an easier recoveries when compared to the other procedures for pilonidal disease. red bumps or lesions sensitive to the touch that may look like a. These codes are used. The 2021 edition of ICD-10-CM M62. 1 Historically, the concept of MASD arose from recognition that many skin lesions identified by nurses in patients at risk for. Case. A 4-mm punch biopsy of the gluteal cleft was performed. Parenteral options include cefazolin, nafcillin, and flucloxacillin. 3 IAD occurs in the perineum, including the labial folds and vulva to the anus in women, and from the scrotum to the anus in men; groin, buttocks, gluteal cleft, and even extending down to the inner and posterior thighs. before i know it is become an open wound. Some symptoms associated with stage 2 pressure ulcers include: pain. The flap is then closed over the ‘shallowed’ valley and sutured to the side outside the cleft. By palpation there is no bony prominence and it is blanchable erythema. Anus: Rashes at the anus can cause rectal bleeding and pain with passing stools. Search Results. Contact dermatitis is an inflammatory skin response to an allergen, chemical, or other agent. Azathioprine 50 mg once daily was added to her longstanding. 309 may differ. The edges are diffuse and irregular. Product placement. Objective: To study the characteristics of five bedridden geriatric patients who presented with herpetic recurrences on the buttocks, gluteal cleft, and perianal region during hospitalization. Bodily secretions. The procedure consisted of excision of the sinus tracts, cysts, and open wounds; raising a skin and subcutaneous tissue flap; and flattening the gluteal cleft. Body habitus may contribute to additional intertriginous sites, such as inframammary skin and. This is the American ICD-10-CM version of L02. Bilateral gluteal and bilateral upper medial thigh flaps were raised and inset to decrease surface area. 312 may differ. Wund-D. The 2024 edition of ICD-10-CM L89. The International Wound Journal is a clinically relevant wound care journal covering the prevention and treatment of wounds and associated skin conditions. Setting: Community private practice with extensive. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. Of the 4 Hispanic whites,. B. A 35-year-old patient is pictured in 2B 6 months after combined bilateral pudendal and gluteal flap pelvic reconstruction. Complications were recorded and are described. Excludes1: pilonidal cyst with abscess . The “intergluteal cleft” is the medical term for your butt crack, which is a common area for rashes. Gluteal augmentation with implants: the area of dissection is marked (gray); one or two incisional accesses are placed in different locations: a single incision can be placed medially in the sacral area (green); two bilateral incisions can be placed in the para-sacral area (blue) or in the gluteal cleft (fuchsia). S72. This is the American ICD-10-CM version of L98. There were,. 000 - Unspecified open wound of lower back and pelvis without penetration into retroperitoneum; S31. Erythematous plaques in axillae - a report of two cases In its general usage, the term pilonidal cyst refers to an area located at the superior aspect of the gluteal cleft in the sacrococcygeal area as. The gluteal cleft is the groove running between each buttock, from the base of the spine to the perineum, which is the area between the anus and genitals. The pits picking (Gips) procedures [ 18 , 20 ] were all carried out in the prone position under a general and local anesthesia combination as described before. ” In ultrarunner translation, that’s the.