Pilonidal disease is a chronic skin infection in the crease of the buttocks,
There are few different surgical options for treatment of Pilonidal disease and this will be discussed on the day of consultation according to severity of disease.Please read below for more information.
The information here is a guide only and does not replace my discussions with you on the day of consultation.
What causes the sinus?
They are simply a cavity under the skin that contains hair. Three factors cause the sinus to form: the buttock cleft, Humidity and hair. The friction and suction created there results in the hairs drilling under the skin.
What are the risk factors for?
-people with coarse hair (Mediterranean background)
What symptoms should I expect from Pilonidal sinus?
- Generally the sinus doesn’t cause much symptoms. Only when they get infected, they become very painful and turn into abscess that needs emergency surgery.
What can be done about the them?
There are few options to treat pilonidal sinus.
Simple lifestyle changes can help preventing them from infection and getting worse:
-Keep the area hair free and dry
-Surgery generally not required if they don’t cause any pain or symptoms.
Once the acute infection settled then it can be treated by cutting out the entire sinus and closing the wound again. The options will be repairing the wound with taking skin flap or closing the wound without flap. The aim with these closure techniques are to flatten the area of buttock cleft.Recently novel endoscopic techniques have become available and these will reduce the change of having big cut in the back.
These options will be discussed during consultation and tailored to your condition.
How do I remove the pilonidal sinus with surgery?
You will be advised to fast prior to the procedure, and the updated details will be given to you from my rooms or nursing team depending on timing of procedure.
This is done under general anaesthesia. Once you are fully sleep I will the remove entire sinus tract and depending on the extension of disease one the techniques will be used. I will discuss the technique prior to operation with you.
What happens after surgery?
-Most patients who undergo surgery will stay for one night.
-You will be given regular simple pain relief medications. Examples include Panadol and Nurofen. Sometimes you require stronger pain relief and this be prescribed in your medication chart.
-Your wound will be checked by nursing staff and will be given medications to prevent clot formation in legs together with white stockings(this will also reduce the risk of clot formation).Your heart rate, breathing rate, Blood pressure and temperature and your blood oxygen levels will be checked regularly.
-You generally can have normal diet and there are no restrictions after anaesthesia
-You may experience having trouble passing urine, and the nursing staff will need to be notified. At times if simple measures don’t help some patients require temporary urinary catheter.
-You will be given a device to help with breathing after surgery if you have underlying lung problem or if having trouble breathing well.
-If you present with abscess after the abscess is drained we will pack the wound with small piece of gauze and cover it with the dressing. These wounds generally heal within 2-3 weeks
-If this was a planned surgery you will have a dressing over the wound and instructions be given to you how to care for the wound before you go home
-You may experience small amount of ooze from the wound for few days.
-You might need to wear a pad for about a week.
-If you require strong pain relief this may cause constipation so you might need over the counter laxatives if simple measure don’t work.
-Try to do light activity shortly after surgery.
-There will be sutures that need to be removed in 2 weeks if your operation was not an emergency operation for an abscess.
-You should not drive for 24 hours after the operation. A medical certificate will be provided if required.
- If you are worried please don’t hesitate to call my rooms for earlier review.
What are the risks of pilonidal sinus surgery?
There are general and specific risks to surgery:
-Heart problems, clots in legs, stroke especially if there are pre-existing serious medical conditions before surgery.
-Delayed/Slow healing of the wound, especially if the area is not hair-free or if you have diabetes or you smoke
-Re-operation if they come back.
What costs to be incurred from this practice?
There will be an out of pocket charge for your procedure from my service. When you present to my rooms for consultation, this is not covered by your private health funds. You will get some of the money for outpatient consultations back from Medicare.
There may be an out pocket expenses for anaesthetic services depending on your level of cover.Please contact Downs anaesthetics for further details. You should ask them ahead of time about this cost. You will also have to pay any hospital excesses that your policy dictates. We will provide you with contact details after consultation so you could check ahead of time.