What to watch out for after treatment
It is usual to keep the area shaved until healing is
complete and the wound has become firm. At the first
sign of any infection or pain developing, advice should
be sought, as this may represent a recurrence.
Recurrence is more frequent in wounds that have been
sutured rather than it those that have been left open.
What would happen if the condition were not
treated? Poilonidal sinuses frequently become
infected. The result of infection is an abscess.
Abscesses are acutely painful and need to be
opened and such wounds cannot be sutured.
The majority of pilonidal sinuses require surgery.
This is best done before any infections occurs.
This sheet describes a medical condition or surgical
procedure. It has been given to you because it relates to
your condition and may help you to understand it better. It
does not necessarily describe your problem exactly. If you
have any questions, please ask your doctor.
Reference:
G “Patient Wise”, Medical
& Health Information for Patients
G www.prodogy.nhs.uk
Compiled at Pre Op Clinic, St Luke’s Hospital, Kilkenny.
Our ref: NM/MN
Reviewed: 10/08/07
Published by the Communications Dept., HSE South,
Ref: 09-06-0043
Designed and Printed by Modern Printers: 056 7721739
Patient information for Pilonidal Sinus
What is it?
A pilonidal sinus is a cavity containing hairs; it occurs in
the cleavage between the buttocks (natal cleft) and can
cause discomfort.
How does it occur?
It is the thought that friction of the skin at the base of
the spine causes hairs to become embedded beneath the
surface. The hairs form small cavities, which develop to
form the “sinus”. Infection of the sinus may lead to an
abscess being formed. An alternative suggestion is that
some people are born with small pits in the skin of this
area. These subsequently collect hair and debris. They
then become infected, producing the pilonidal sinus or
abscess, which is painful.
Why does it occur?
Pilonidal sinus occurs more frequently in dark-haired men
or women whose hair tends to be coarse in texture. Dark
coarse hair is more likely to become embedded beneath
the skin than fine hair. Nevertheless, women or fair-haired
people are sometimes affected. Rarely, a similar condition
can occur between the fingers of hairdressers. Again the
cause is thought to be embedding of hairs beneath the skin
as a result of their job.
What does treatment involve?
The sinuses beneath the skin are frequently far more
extensive than they appear on the surface. A pilonidal
sinus should therefore be cut out (excised) to prevent
infection and abscess formation.
Under general
anesthetic the sinus is examined and its extent assessed.
A dye maybe injected into it to demonstrate the size of
the cavity. The whole cavity is then cut away. If the
resulting defect is not large, it may be closed with
stitches. If the cavity is large it may be left open and
allowed to heal naturally. Occasionally plastic surgery is
performed to move the surrounding skin in such away
that it closed the defect. A wound that is closed using
stitches will usually heal quicker that one is left open.
Stitches cannot always be used on large cavities.
They would be too tight and the wound would break
down. If the infection or an abscess is present, the pus
is drained and the wound left open. It does not heal if
it is stitched. Stitched wounds take about 10 days to
heal. After this time the stitches may be removed,
although it will take about another month before the
scar becomes firmer. Strenuous exercise should be
avoided during this period. Wounds, which are left
open, are dressed regularly once the wound is clean.
The dressings can be continued either at a subsequent
visit or by the district nurse. Such wounds invariably
take longer to heal than stitched wounds. The length of
time depends on their size. On average, most take about
a month to heal and require some form of dressing
during this time.
Complications
With all surgical procedures certain complications can
occur, these would include:
G Infection
G Hemorrhage or bleeding
G Deep vein thrombosis (in order to help prevent this,
patients are given injections of low molecular
heparin and are fitted with elastic stockings.
What to watch out for during treatment
If the wound is healing satisfactorily, the area is shaved
regularly to prevent further problems developing from
newly growing hairs. Occasionally if a wound has been
stitched, it may breakdown. This occurs when there is
tension on the stitches or infection has occurred. No
harm will come as a result. The sutures will then be
removed and the wound allowed to heal as if it has been
left open in the first place.