PILONIDAL SINUS

WHAT IS PILONDIAL SINUS?

It is a small opening that occurs in the cleft usually at the top of the buttock. It usually contains hair, dirt, debris.

WHAT CAUSES PILONIDAL SINUS?

A combination of

• Hormonal imbalance (Hence it generally occurs after puberty)
• Excessive hair
• Friction from clothes
• Spending a long time sitting.

SYMPTOMS

• Single or multiple depressions in the midline, lower back just about the natal cleft.
• If infected
  • Pain
  • Pus/blood/discharge from the hole.
  • Reddened, sore skin around the area.

INVESTIGATIONS - Local clinical examination is usually sufficient.

WHY SHOULD PILONIDAL SINUS BE TREATED SURGICALLY?

Treatment

• There are no medicines which can make pilonidal sinus disappear.
• Only infection in pilonidal sinus can be controlled by medicines.
• Antibiotics are given prior to surgery in case of infected pilonidal sinus.
• Surgery is always an elective procedure.

AFTER SURGERY

After the excision it be either

• Left open – The patient is called for daily dressing and the wound heals in nearly 3-4 weeks depending upon the size of the wound. Generally, the patient is called for 7-10 days daily dressing in the hospital and then advised to continue dressing at home.
• Closure – primary closure if possible reconstruction by plastic surgery.
  • In this situation, hospitalization is required for 3-4 days.
  • The patient needs to be immobilized – needs to remain in the prone position i.e. lying on the chest and back upwards.
  • A small drain in kept at the surgery site and the patient is advised to go home with the drain.

INSTRUCTIONS AFTER SURGERY

• Hospitalization -The duration depends upon the type of surgery. It varies usually from 2 days – 5 days.
• Requires daily dressing.
• You may experience pain, discomfort and a slight watery discharge from the operated site for 7-10 days.
• Rest is recommended for 7-10 days and you can resume the work after 10 days.

Pilonidal sinus surgery has no effect on continence. The patient can start passing motions immediately after surgery and resume normal activity after 1 week.