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Pilonidal sinus: Surgical procedure

Treatment of pilonidal sinus depends upon the presence of infection. There are various techniques that a surgeon can opt depending upon the size, location and condition of the sinus.
I & D: Incision and drainage is generally performed under general or spinal anaesthesia. The procedure involves opening up of the sinus, followed by pus drainage.
Indication: Pilonidal sinus with pus
Advantage: Minor operation and patient can return home on the same day
Wide excision: The procedure involves wide excision to remove the section of skin containing the sinus. The wound is left open??and packed with a dressing.Dressing needs to be changed daily.
Indication: Recurring pilonidal sinus infections
Advantage: Low chances of infection returning
Excision and primary closure: The procedure involves excision of the affected skin of the sinus followed by closing and sealing of the wound with stitches. The wound can be closed by using a flap of patient???s own skin and tissue.
Indication: Recurringpilonidal sinus infection
Advantage: Wound heals quickly
Cystectomy: It is the surgical removal of a pilonidal cyst or tract that has extended from a sinus. It may involve the excision of a small amount of tissue or rotating of the adjacent tissues into the defect after excision.
Indication: Pilonidal sinus with cyst
Advantage: Better chances of healing of cyst cases
What will happen after surgery?
Patient may feel slight discomfort for one week
Patient needs to take medication as prescribed by physician
Keep the wound clean and dry
Wear loose-fitting cotton clothes
Eat high-fibre foods to avoid constipation

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