Pilonidal sinus

What is pilonidal sinus disease?

Pilonidal sinus is a chronic, inflammatory condition that affects the top of the natal cleft (between the top of the buttocks).  It is thought to be caused by the in growth of hairs into the skin in this area; the resulting tract (known as a sinus) can become inflamed and infected.  The inflammatory process that results leads to persistent, recurrent infection, and can cause offensive discharge and abscess formation.  It is more common in young men, but tends to burn out over time and is rarely seen in people once they reach 40.

What treatment options are there?

Patients are advised to keep the area at the top of the natal cleft hair-free, either by shaving or through the use of depilatory creams.  If an abscess develops, emergency drainage is required; the wound is usually left open and packed.  For patients who have chronic discharge and repeat infections, surgical excision may be indicated.  There are a number of operations that are performed, depending on the extent of the disease; these include excision and primary closure and plastic surgical flap reconstructions.  Complications of surgery include wound infections, delayed and non-healing wounds and recurrent disease.  Your surgeon will be able to advise you which surgical option is best for you and will be able to advise you on potential risks and complications.

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