What is a Pilonidal Sinus?

• • Definition : A pilonidal sinus is a small hole or tunnel in the skin, usually developing in the cleft of the buttocks where the buttocks separate.
• • Characteristics : Multiple holes may develop and are often linked by tunnels under the skin.
• • Symptoms : Generally, pilonidal sinuses are symptomless unless infected, which can lead to pain, redness, swelling, and abscess formation.

What Causes a Pilonidal Sinus?

• • Primary Cause : Thought to be caused by loose hair piercing the skin.
• • Risk Factors : Obesity, having a lot of body hair, and jobs involving prolonged sitting or driving can increase the likelihood of developing a pilonidal sinus.

How are Pilonidal Sinuses Treated?

• • Hygiene : Keeping the area clean and dry, and removing hair near the sinus can help reduce infection risk.
• • Infection Management :
• • Antibiotics : Used if the sinus becomes infected.
• • Incision and Drainage : A minor operation to drain pus from an abscess.
• • Surgery : If infections recur, surgical removal of the sinus may be necessary. Techniques include wide excision, excision and primary closure, and using fibrin glue.

What is Incision and Drainage?

• • Procedure : Involves opening the sinus and draining pus, typically done under general anaesthetic.
• • Recovery : It's a minor operation, allowing most patients to return home the same day or the next day.

What are the Surgical Options for Recurring Pilonidal Sinus Infections?

• • Wide Excision : The sinus is cut out and the wound is left open to heal, packed with a dressing. This method has a low recurrence rate but requires long healing time.
• • Excision and Primary Closure : The sinus is removed and the wound closed with stitches. This heals quickly but has a higher chance of recurrence.
• • Fibrin Glue : A less invasive option where ingrown hairs and debris are scraped out and the area sealed with a special glue.

What is the Post-Surgery Care for Pilonidal Sinus?

• • Pain Management : Pain relief is provided post-operation.
• • Wound Care : Important to keep the wound clean and dry, avoid using soap, and follow specific instructions from your surgeon.
• • Lifestyle Adjustments : High-fiber diet to soften stools, avoid strenuous activities for a few weeks, and wear loose-fitting cotton underwear.

What are the Complications of Pilonidal Sinus Surgery?

• • Possible Issues : Recurrence of the sinus and infection at the wound site.
• • Signs of Infection : Pain, redness, swelling, high temperature, fluid or pus leakage, and unpleasant odor. Contact your doctor if these occur.

Who is Affected by Pilonidal Sinuses?

• • Prevalence : Rare, affecting about 26 in 100,000 people each year.
• • Demographics : More common in men than women, typically affecting men at an average age of 21 and women at 19. Less common in children and those over 45.

What is a Perianal Abscess?

• • Definition : A collection of pus in the area around the anus and rectum, often a result of an infection.
• • Symptoms : Severe pain, swelling, redness, and fever.
• • Treatment : Involves drainage of the abscess, often with antibiotics to manage the infection.

How are Perianal Abscesses Treated?

• • Drainage : The primary treatment involves draining the abscess to remove pus.
• • Antibiotics : Used if there are signs of a broader infection.

What is the Connection Between Pilonidal Sinus and Perianal Abscess?

• • Shared Characteristics : Both can involve abscess formation and require similar treatment approaches such as drainage and antibiotics.
• • Distinct Locations : Pilonidal sinuses occur in the cleft of the buttocks, while perianal abscesses occur around the anus and rectum.

What is Laser Therapy for Pilonidal Sinus?

• • Laser Therapy : A minimally invasive option where a laser is used to remove the pilonidal sinus.
• • Benefits : Reduced pain, quicker recovery, lower recurrence rates, and minimal scarring.
• • Procedure : Performed under local or general anaesthetic depending on the case.

By addressing these questions and using advanced treatments like laser therapy, patients can achieve effective management of pilonidal sinus and related conditions with minimal complications.