Use blue dye on a canula to assess whether sinuses are connected and extent of disease
Mark incision, about 6cm long and 4cm wide, incorporating all disease, shifted off midline by 2cm. The inferior pole of excision is generally the natural high point of the cleft, to flatten as much as possible.
Incise down to fascia
Raise a flap from centrally, just above the fascial plane, that will be pulled across the hole
10Fr RediVac can be left, although not done by BD
Close with interrupted subdermal undyed Vicryl (picking up some off-midline fascia to pull the closure off-midline) and 3/0 Nylon vertical mattress
