PILONIDAL SINUS / COMPLEX DISEASE

Causes of Pilonidal sinus is believed to be chiefly bifactional

• Seen in hirsute (hairy individuals) individuals with potential for free hair to lie within the natal cleft
• Presence of pits/dimples within the natal cleft area that promote the entrance of loose hair/debris into the subcutaneous tissue

Once a pilonidal complex has been definitely identified, surgery is usually the treatment of choice.  Sometimes if this condition manifests with an abscess formation, then a procedure to drain the abscess will be required as a pre – requisite.  Occasionally abscess drainage alone may suffice.

Surgery is done under General Anathesia where the entire diseased complex is excised.  Primary closure of this wound is almost always done (no regular dressings required as there is no open wound). This is usually achieved by using a Cleft lift / modified Cleft lift procedure.

Recently the use of other modalities such as laser therapy or ‘pit-picking’ in selective early stage disease has been successfully implemented.

4 – 5 hours after surgery, the patient consumes fluids and a full diet.  The patient is mobilised within 4-5 hrs following surgery.A drain usually stays in place for approximately 48 hrs.The patient can thereafter get discharged from hospital and follow – up at the clinic at regular intervals. Returns back to work usually occurs 5-7 days later.