Pilonidal Sinus

It is a sinus (Tract which opens at one end only) situated a short distance behind anus (at the position of tail bone) & generally containing hairs. Other areas of occurance can be finger web in barber,under arm, between the thighs, umbilicus.
The diseases mostly affects men, in particularly hairy men. The combination of buttock friction and shearing forces in that area allows shed hair or broken hair which have been collected in cleft resulting into infection abscess burst and form sinus.

Pilonidal_Cyst_final

Treatment: 
Treatment depends as per complaint of the patient.

  1. If the patient presented with acute abscess then surgical procedure is two stage. In first stage, Incision and drainage of abscess, dressing and antibiotics. Once the patient gets relief then definitive treatment that is wide excision of sinus tract and removal of all debris and hair and primary closure.
  2. If the patient presented with sinus without abscess then it is done in one stage procedure.

We are routinely doing this procedure at abhishek day care centre as a day care procedure.

After surgery patient is advised to keep the wound clean. One can use hair-dryer to keep the wound dry. To prevent hair entering into the wound, skin edges should be shaved weekly.

On Examination: 
Patient complain of intermittent pain, swelling , and discharge at the base of spine. There is often history of repeated abscess that have burst spontaneously or which have been incised, usually away from midline. The primary sinus may have one or many openings. All of which are strictly in the midline