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Last Updated: May 23, 2023

Pilonidal Sinus - Non Surgical Treatment Is Better Than Surgery/Z-Plasty!

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Dr. S K Singh, Sushruta Ano Rectal Institute Piles And Fistula TreatmentGeneral Surgeon • 37 Years Exp.M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
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Pilonidal sinus presents itself as a nodular swelling or an opening in lower spinal region. There might be intermittent pus discharge from this swelling. Hairs protruding out from this opening/ swelling may also be seen. Pilonidal Sinus mostly happens to people who have hairy skin. Hairs invade in the skin and become source of infection. As a result pus formation is there which intermittently gets discharged through a tract opening on the skin.

Treatment for Pilonidal Sinus:

Medicinal treatment - Homeopathic/ Allopathic/ Ayurvedic - Oral medicines are not of much use in treating Pilonidal Sinus. Problem keeps on appearing after some time of remission. So, just continuing oral medicine in hope of treatment will only complicate the problem. So, usually surgery is advised for Pilonidal sinus. But it is not a good choice as the chances of recurrence of problem are pretty high after surgery. However, Pilonidal Sinus can be conveniently treated by Graded Ksharsutra Treatment.

No hospitalization or bed rest is required in this treatment. Patient can continue his normal routine activities as usual during this treatment. In this treatment first of all; Sinus tract is defined with the help of MRI sinogram or carefully done manual probing. Once the tract is defined properly; Graded Ksharsutra - a specialized medicated thread is placed in sinus tract. Medicine present in this thread exerts strong debridement effect and thus induces healing by fresh and healthy granulation tissue.

With the introduction of Graded KsharsutraTM; Pilonidal Sinus treatment has become more convenient. Medicine present in Graded KsharsutraTM works for 5 to 7 day so old Ksharsutra needs to be replaced with a new Ksharsutra at a week or 10 days interval. No. of Graded Ksharsutra changes required for complete healing of sinus depends on length of Sinus tract. It is observed that sinus heals @ 0.5 to 1 cm per sitting i.e. to say that a 3 cm long sinus tract needs 4 to 5 Graded Ksharsutra changes at weekly interval.

Why Non Surgical treatment is better than Surgery for Pilonidal Sinus:

• No hospitalization or bed Rest required

• No chance of surgery related complications

• Chances of recurrence are there in surgery while recurrence is not seen in Graded KsharsutraTM treatment

• Graded KsharsutraTM is done under local anesthesia which is always safer than general anesthesia/ Spinal Anesthesia required during surgery

• Normal routine activities can be continued as usual during Graded KsharsutraTM Treatment

• Graded KsharsutraTM Treatment is more economical than surgery for Pilonidal Sinus.

So, we can conclude that non surgical Ksharsutra treatment is better than Surgery in case of Pilonidal Sinus.

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