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Pilonidal Sinus Excision

Overview

Pilonidal sinus excision is a surgical procedure used to treat a pilonidal sinus, a small cyst or abscess that occurs in the cleft of the buttocks near the tailbone. The condition is caused by trapped hair, debris, and dead skin that can lead to infection, inflammation, and pus formation. If left untreated, it can cause chronic pain, infection, and may lead to sinus tracts (tunnels under the skin). Surgery is the most definitive treatment option, where the sinus and surrounding infected tissue are removed.
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How is Pilonidal Sinus Excision Done?

Preoperative Assessment:
  • A thorough medical history and physical examination are performed.
  • Blood tests, if required, to check for any underlying health conditions.
  • Inform the surgeon of any medications or supplements being taken.
  • If you smoke, it is advised to quit before the surgery to promote better healing.
Pre-surgery Instructions:
  • Fasting is required for several hours before surgery (usually 8-12 hours) if under general anesthesia.
  • Antibiotics may be prescribed preoperatively to reduce the risk of infection.
  • Shaving or cleaning the area may be required to minimize the risk of hair causing complications post-surgery.
Anesthesia:
  • The procedure is performed under either local, regional, or general anesthesia depending on the extent of the surgery and patient preference.

Incision and Excision:
  • The surgeon makes an incision over the pilonidal sinus and removes the infected sinus, surrounding tissue, and any sinus tracts.
Types of Procedures:
  • Wide Excision: Removal of a large portion of tissue around the sinus, followed by leaving the wound open (open healing).
  • Primary Closure: After excision, the wound is stitched closed, which allows faster healing.
  • Flap Techniques: In cases of recurrent or complicated sinuses, a flap of healthy tissue may be used to close the wound.
  • Drainage: A drain may be placed to prevent fluid buildup and reduce the risk of infection or abscess formation.
  • Closure: The wound can be left open (secondary healing) to heal naturally over time or closed with sutures (primary healing), depending on the size of the wound and the surgeon's decision.
  • Duration: The surgery typically lasts between 30 minutes to 1 hour, depending on the complexity.

  • Infection: Despite precautions, wound infections may occur, leading to delayed healing or abscess formation.
  • Recurrence: The sinus may return in a small percentage of patients, particularly if hair continues to irritate the area.
  • Wound Dehiscence: If the wound is closed with sutures, there is a risk that the wound may reopen.
  • Bleeding or Hematoma: Blood clots can form in the area of surgery.
  • Scarring: There will be some scarring, especially in procedures that involve wide excision or secondary healing.
What are the Benefits of Pilonidal Sinus Excision ?
  • Permanent Resolution: Surgery offers a high chance of completely removing the pilonidal sinus and preventing further complications.
  • Symptom Relief: Most patients experience relief from pain, swelling, and recurrent infections after healing.
  • Prevents Recurrence of Abscesses: Excision helps eliminate the chance of recurrent abscess formation, which can significantly improve the patient's quality of life.
Specialty for Pilonidal Sinus Excision

The surgery is typically performed by Colorectal Surgeons or General Surgeons, who have expertise in managing conditions of the lower digestive tract and soft tissue infections. Dermatologists may also be involved in more superficial or early-stage cases.

Infrastructure Facilities for Pilonidal Sinus Excision

  • Surgery: Most pilonidal sinus surgeries are performed in outpatient settings, allowing the patient to return home the same day.
  • Operating Room Facilities: A sterile environment with necessary surgical instruments and anesthesia equipment.
  • Postoperative Care Facilities: Wound care services and follow-up appointments are crucial to ensure proper healing. Facilities should offer dressing changes and wound management for patients who have open wounds.
  • Pain Management: Availability of pain relief medications and aftercare services is essential for recovery.

FAQs

During the procedure, anesthesia ensures that you do not feel pain. Some discomfort or pain can be expected during recovery, but it can be managed with pain relievers.

Recovery depends on whether the wound is left open or closed. Open healing may take 4-8 weeks, while primary closure may take 2-4 weeks.

While surgery reduces the chance of recurrence, it can still recur in a small percentage of cases. Following postoperative instructions and maintaining hygiene can help prevent recurrence.

Keep the area clean and dry, follow the wound dressing guidelines, and avoid activities that can strain the area. Shaving or laser hair removal around the surgical site may be recommended to prevent hair buildup.

You can return to light activities in a week or two, but heavy physical activities or prolonged sitting should be avoided until full recovery.

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Copyright 2025 TRSCH - All Rights Reserve

Website Design and Development by Sterco Digitex

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