Pilonidal Sinus

A pilonidal sinus (PNS) is a tiny opening or tunnel in the skin. It might swell up with liquid or pus, leading to the development of a cyst or abscess. It appears in the buttocks’ upper cleft. Hair, sand, and other debris are frequently seen in a pilonidal cyst. It may be excruciatingly painful and usually becomes infected, leaking pus and blood with an unpleasant odour.

A PNS is a disorder that mostly affects men and is common among adolescents and young adults. Also, those who spend a lot of time sitting down, such as cab drivers, are more likely to experience it.

Causes of Pilonidal Sinus

This condition’s specific cause is unknown; however, it is thought to be a result of a mix of reasons, such as shifting hormones, hair growth, friction from clothing, or sitting for extended periods of time.

Sitting might force the hair in the region to push back beneath the skin because of the friction it creates. The body responds to this hair in a manner similar to how it would to a splinter by mounting an immunological attack against it since it perceives it as foreign. The cyst that surrounds your hair is created by this immunological reaction. It could be worse when several sinuses can occasionally join under the skin.

Symptoms of Pilonidal Sinus

The only obvious symptom you may have at first is a little depression on the surface of your skin that resembles a dimple. The depression, however, will swiftly transform into a cyst or an abscess once it contracts an infection. Infection can show the following symptoms:

• Pain when standing or sitting
• Swelling of the cyst
• A bad odour caused by pus or blood flowing from the abscess.
• Patch of skin that is irritated and red.
• An increase in the number of sinus tracts or skin holes.
• Hair poking out from the wound.

How is a Pilonidal Sinus diagnosed?

Your doctor will start by doing a thorough physical examination on you. You will probably be asked a few questions about your medical and family history once you arrive at the hospital. Your buttocks’ crease will be examined for any indications of a pilonidal sinus.

The anorectal expert will be able to identify a prominent and severe pilonidal sinus just by looking at the patient physically. The following tests are advised for diagnosis in the case that the doctor is unable to diagnose the problem only by looking at the pilonidal cyst. The following are common tests carried out on the pilonidal sinus:

• Digital Examination
• Visual Inspection
• Lab swab test

In order to check for any gastrointestinal diseases, the pilonidal sinus specialist may additionally advise procedures like colonoscopy, sigmoidoscopy, and anoscopy. If the doctor determines that your pilonidal sinus disease is not too serious, the doctor could suggest medications for the time being. On the other hand, if the condition is serious, the doctor can advise that you have surgery for the pilonidal sinus.

What is the treatment for pilonidal sinuses?

Non Surgical Treatment

If your disease is detected early on, you do not have severe pain, and there are no signs of inflammation, your doctor would most likely prescribe a broad-spectrum antibiotic. An antibiotic that works on a variety of bacteria is known as a broad-spectrum antibiotic. You should schedule a follow-up examination, routinely shave the affected area, and pay close attention to your cleanliness, as advised by your doctor.

Surgical Treatments

• Lancing – Under the sedation of local anaesthetic, this procedure is performed. The proctologist administers an anaesthetic to the patient to make them comfortable before starting the procedure. The doctor next cuts into the abscess with a knife and removes the filth, blood, hair, and debris. The doctor would then apply a sterile bandage to the wound after cleaning it, allowing it to heal inside. Up to four weeks may be required for the recovery.
• Incision & Drainage – Local anaesthetics are used during this treatment to make the afflicted region numb. To remove the pus and infectious fluid from the cyst, the surgeon creates an incision in it. The doctor also covers the hole with gauze and lets it heal naturally.
• Pilonidal Cystectomy – It is the surgical excision of the whole pilonidal cyst. For a recurring cyst, doctors used to carry out this conventional operation. Moreover, general or local anaesthetic is administered before it is carried out. The damaged skin, as well as the underlying tissues, dead cells, and hair follicles, are taken out by the surgeon. The doctor inserts a catheter to drain the cyst’s contents in circumstances where the infection is severe.
• Laser Pilonidal Sinus treatment – A powerful laser beam is used by the surgeon to seal off the sinus during the treatment. In order to prevent a recurrence of the infection, the doctor also makes sure to remove the whole pilonidal sinus pit. Compared to the open surgical options listed above, it is a simpler and more precise procedure to execute.

What complications are related to Pilonidal Sinus (PNS)?

Complications from PNS can take many different forms. Infection of the wound and a PNS recurrence even after surgery are two examples.

During Surgery – Surgery performed by qualified doctors at Apollo Hospitals, Karnataka, considerably reduces your risk of complications.

Yet, just as with other surgical procedures, the success or complications of pilonidal sinus surgery also heavily depend on how serious the condition is and how much expertise the physician has. A patient may experience any of the following complications during or after having their pilonidal sinus surgery.

• Severe pain
• Swollen, inflammatory skin
• A body temperature of 100.4°F.
• Pus and blood oozing from the wound
• A bad smell emanated from the wound.
• Reaction to anaesthesia.

If left Untreated – There is a risk of developing painful, large abscesses if the pilonidal sinus is left untreated for a long period. Blood and purulent discharge are also extremely likely to seep out of the sinus tract. The likelihood of having numerous sinus tracts increases if a chronic pilonidal sinus is not treated for a long period of time. An individual is more likely to get skin cancer if they ignore pilonidal sinus or do not treat recurrent pilonidal sinus.

What can be done to prevent Pilonidal Sinus?

You can take a number of measures to lessen your risk of developing pilonidal cysts or to stop them from returning. These steps consist of the following:

• Cleaning and drying your buttocks on a regular basis.
• Limiting the amount of time spent sitting.
• Shaving the area around your buttocks.
• Reducing risk by losing weight.

Apollo Hospitals, Karnataka, are the finest multispeciality hospitals in the state, offering comprehensive care and treatment to patients 24*7. We have the latest tools and technology, cutting-edge medical facilities, top-of-the-line infrastructure, and a team of highly experienced physicians, surgeons, and medical staff who produce outstanding treatment outcomes. We use highly advanced technology and have skilled general surgeons and dermatologists that execute pilonidal sinus surgery operations for the desired outcomes, which speaks for the valuable trust & confidence our patients have in us.