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Pilonidal Sinus 

Understanding Pilonidal Sinus:

A pilonidal sinus is a small tunnel or cavity that forms under the skin near the tailbone (coccyx). It often contains hair, debris, and bacteria, leading to infection, inflammation, and the formation of abscesses or cysts. Pilonidal sinuses are more common in young adults and may cause pain, swelling, redness, and drainage of pus or blood. Although, it is commonest in the natal cleft, pilonidal sinus can be found near umbilicus (navel), and armpits.

Causes and Risk Factors: The exact cause of pilonidal sinus is not fully understood, but several factors may contribute to its development, including:

  1. Hair Accumulation: Loose hair and debris can get trapped in the skin near the coccyx, leading to the formation of sinus tracts.
  2. Friction and Pressure: Prolonged sitting, friction from clothing, and pressure on the buttocks area can irritate the skin and contribute to pilonidal sinus formation.
  3. Genetic Predisposition: Some individuals may have a genetic predisposition to developing pilonidal sinus, especially if other family members have experienced the condition.
  4. Poor Hygiene: Inadequate hygiene practices, such as infrequent cleaning of the buttocks area, can increase the risk of infection and pilonidal sinus.

Symptoms and Diagnosis Common symptoms of pilonidal sinus include:

  1. Pain and Tenderness: Discomfort and tenderness in the lower back or buttocks, especially when sitting or moving.
  2. Swelling and Redness: Inflammation and redness around the pilonidal sinus area.
  3. Drainage of Pus or Blood: Fluid or pus may drain from the sinus tract, leading to soiling of clothing or bedding.
  4. Fever and Fatigue: Infection-related symptoms such as fever, fatigue, and malaise may occur in severe cases.

Diagnosis of pilonidal sinus is typically based on a physical examination, medical history, and imaging studies such as ultrasound or MRI to assess the extent and severity of the condition. Imaging is rarely needed for diagnosis, unless the disease is extensive or in atypical areas (like umbilicus and armpits).

Treatment Options:

  1. Incision and Drainage: For acute abscesses or infected cysts, a minor surgical procedure may be performed to drain the pus and alleviate symptoms.
  2. Excision and Closure: In cases of chronic or recurrent pilonidal sinus, surgical excision of the sinus tracts and closure of the wound may be recommended to prevent future recurrences. This includes use of flaps ( Karydakis and Limberg).
  3. Minimal Excision Technique: Manu Shankar specializes in a minimally invasive technique called the “Minimal Excision Technique” (MET), which involves removing the affected tissue with minimal disruption to surrounding healthy tissue, leading to faster healing.
  4. Laser Ablation: In select cases, laser ablation may be used to treat pilonidal sinuses, providing precise and effective removal of the affected tissue.

Conclusion: Pilonidal sinus can be a challenging condition, but with the expertise of Dr. Manu Shankar and the advanced treatment options available, relief and healing are achievable. If you’re experiencing symptoms of pilonidal sinus or seeking expert guidance on surgical options, schedule a consultation with Dr. Manu Shankar today for personalized care, effective treatment solutions, and a path towards a healthier, pain-free life.