Pilonidal sinus
What is a pilonidal sinus?
Pilonidal means, "nest of hair" in Latin pilus hair nidus nest. Hair follicles become inflamed resulting in an abscess or sinus formation. Pilonidal sinus are generally found in the natal cleft (bottom crease) but can occur in the axilla, the umbilicus or the penis. This disease is usually found in young adults with thick, stiff body hair and is rarely seen after the age of 40 years. This disease effects more males than females.
Most common site- natal cleft
What causes pilonidal sinuses?
The condition results from a reaction to hairs embedded in the skin. The hair or hairs grow towards the root and become embedded in the follicle. Once this becomes infected it develops a subcutaneous abscess (cavity below the skin surface). After the abscess resolves a sinus cavity with a small tract, opening on the skin may form. This is a pilonidal sinus.
What are the symptoms of pilonidal sinus?
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Pain and swelling at the top of the natal cleft (bottom crease)
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Abscess -this may rupture by itself, but will not heal and constantly discharges fluid that is clear, cloudy, bloody or there may be a discharge of pus with a foul odour. The fluid is discharged from the pilonidal sinus (this is a cavity below the skin that connects to the surface via a small opening or tract). A large majority of patients require an operation to eliminate this sinus
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Fever, malaise and tiredness from repeated infection
What is the treatment for pilonidal sinus?
Acute abscess - this is relieved by making an incision and allowing the pus to drain, this reduces the inflammation and pain.
Chronic sinus - sinuses need to be excised (surgically removed). Procedures range from unroofing (removing the very top part of the cavity) to excision and repair with a flap. Your doctor will discuss the options and procedure with you.
What to expect after your operation?
Your wound may be left open (no sutures to close the
skin) and the cavity will require a dressing. The wound will heal from
the base up and may take some weeks depending on the size of the wound.
If this is the case you may be discharged home before it heals and a
community nurse can be arranged to visit you at home and perform the
dressings.
If the wound is closed you will need to keep it clean and dry.
Useful Contacts and Further Information
Concord Hospital has an internationally recognised Colorectal Unit and can be contacted on 97678360
Contact your General Practitioner
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