Surgery for Pilonidal Sinus

Pilonidal sinus surgery is a procedure to treat a pilonidal sinus, which is a small hole or tunnel in the skin at the bottom of the tailbone (coccyx) that can become infected and filled with pus. The goal of surgery is to remove the infected tissue and promote healing.

Types of Surgery

There are several types of surgery for pilonidal sinus, including:

• Incision and Drainage (I&D): This is a minor procedure where the surgeon makes a small incision to drain the pus and infected tissue. The incision is usually left open to heal from the inside out.
• Excision with Primary Closure: In this procedure, the surgeon removes the entire pilonidal sinus tract and closes the wound with stitches. This method has a higher risk of recurrence but can result in faster healing times.
• Excision with Open Wound Healing: Similar to I&D, the surgeon removes the infected tissue, but the wound is left open to heal from the inside out. This method reduces the risk of recurrence but can take longer to heal.
• Cleft Lift Procedure: A more advanced procedure where the surgeon lifts the cleft (the area between the buttocks) and removes the infected tissue, then closes the wound with stitches or leaves it open to heal.
• Laser Surgery: A minimally invasive procedure that uses a laser to remove the infected tissue and promote healing. This method is less common but can result in faster recovery times.

Preparation for Surgery

Before undergoing surgery, patients typically:

• Stop taking blood-thinning medications (e.g., aspirin, ibuprofen) to reduce the risk of bleeding during and after surgery
• Avoid eating or drinking for a certain period before the procedure
• Remove any hair from the affected area to reduce the risk of infection
• Take antibiotics to prevent infection, if prescribed by the surgeon

Risks and Complications

As with any surgery, there are risks and potential complications associated with pilonidal sinus surgery, including:

• Infection
• Bleeding or hematoma (blood clot)
• Pain or discomfort during recovery
• Recurrence of the pilonidal sinus
• Nerve damage or numbness in the affected area
• Scarring or keloid formation

Recovery and Aftercare

After surgery, patients typically:

• Experience pain or discomfort, which can be managed with medication
• Need to rest and avoid strenuous activities for several days or weeks
• Require follow-up appointments with the surgeon to monitor healing and remove stitches (if applicable)
• Need to keep the affected area clean and dry to promote healing and prevent infection
• May need to take antibiotics to prevent infection, if prescribed by the surgeon

Outcomes and Prognosis

The outcome of pilonidal sinus surgery depends on various factors, including:

• The type of surgery performed
• The severity of the infection or condition
• The patient's overall health and medical history
• Adherence to post-operative instructions and follow-up care

In general, most patients can expect:

• A significant reduction in symptoms and pain
• Improved quality of life
• A lower risk of recurrence (depending on the type of surgery)