Treatment of pilonidal sinus depends upon the presence of infection. There are various techniques that a surgeon can opt depending upon the size, location and condition of the sinus.
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I & D : Incision and drainage is generally performed under general or spinal anaesthesia. The procedure involves opening up of the sinus, followed by pus drainage.
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Indication : Pilonidal sinus with pus
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Advantage : Minor operation and patient can return home on the same day
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Wide excision : The procedure involves wide excision to remove the section of skin containing the sinus. The wound is left open and packed with a dressing.Dressing needs to be changed daily.
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Indication : Recurring pilonidal sinus infections
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Advantage : Low chances of infection returning
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Excision and primary closure : The procedure involves excision of the affected skin of the sinus followed by closing and sealing of the wound with stitches. The wound can be closed by using a flap of patients own skin and tissue.
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Indication : Recurringpilonidal sinus infection
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Advantage : Wound heals quickly
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Cystectomy : It is the surgical removal of a pilonidal cyst or tract that has extended from a sinus. It may involve the excision of a small amount of tissue or rotating of the adjacent tissues into the defect after excision.
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Indication : Pilonidal sinus with cyst
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Advantage : Better chances of healing of cyst cases
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What will happen after surgery
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Patient may feel slight discomfort for one week
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Patient needs to take medication as prescribed by physician
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Keep the wound clean and dry
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Wear loose-fitting cotton clothes
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Eat high-fibre foods to avoid constipation
