Pilonidal Sinus Surgery: Purpose, Procedure, Benefits and Side Effects

Pilonidal sinus surgery refers to a common treatment procedure for pilonidal sinus. A pilonidal cyst is observed at the bottom of the tailbone. It is composed of hair and skin debris which ultimately leads to many problems in everyday life. Pilonidal sinus surgery is an effective way to treat them evidently.

Summary: Pilonidal sinus surgery is utilized to treat pilonidal cysts.

Pilonidal sinus surgery involves the drainage and incision of the affected area. Every procedure involving this is regarded as minimally invasive. However, there are various procedures for removing the pilonidal sinus, available out there. Some of them are:

• Wide local excision: The area removed consists of the tissue overlying the muscle called the fascia of the sacrum. The wound is medicinally packed and left for healing.
• Excision followed by marsupialization: The cyst's roof is eliminated during the excision procedure. In this case, fibrous tissue is sutured.
• Excision with primary closure: After removing the cysts and sinus tracts, the incised area is surgically closed.
• Excision with intricate closure: After removing the sinus tracts and cysts, the area is surgically closed by using a flap technique. The flaps aid faster recovery and are sutured to the underside of the skin bridge.
• Laser Piloniodoplasty (LPP): It involves the use of Leonardo Laser and is considered minimally invasive of all. In this procedure, a small cut is made to drain the pus out. The laser fibre is used to seal the entire sinus tract.
• Z-plasty: It involves a common transportation flap technique. Scar revision is a common procedure in plastic and reconstructive surgery. Two triangular flaps are created in this procedure.
• Cleft lift or closure: During this surgery, the abscess cavity is not excised. It is left open and curetted. The infected area along with the hair and skin debris is removed carefully.
• Limberg flap/gluteal flap surgery: This type of surgery involves using the whole pilonidal sinus and the affected tissues around it. The removed skin is covered by healthy skin taken from the bottom. The stitches of the wound are removed at the hospital after about 2 weeks of surgery.

Summary: Pilonidal sinus surgery is differentiated into some distinct categories as stated above.

Pilonidal sinus surgery helps in the eradication of pilonidal cysts. Along with this, it also possesses other benefits like:

• Relieving the recurring pain
• Draining pus or abscess
• Provides quick recovery
• Control it from spreading
• Prevent it from becoming an abscess or a sinus cavity
• Ease the discomfort

Summary: Pilonidal sinus surgery helps us to experience benefits like treating pain, and discomfort, preventing infections, etc.

Pilonidal sinus is a serious disorder that needs urgent medical attention. It starts creating discomfort in carrying out normal activities such as sitting, jumping, walking, etc. To overcome these issues, pilonidal sinus surgery is advised. It drains out the pus or abscess and helps to control the infection.

Summary: Pilonidal sinus surgery helps to control the disorder and prevents it from spreading to other areas.

Along with various benefits, pilonidal sinus surgery also possesses some potent risks. These are-

• Oozing pus
• Tenderness
• Fever
• Redness
• Bruise

Summary: Pilonidal sinus surgery comprises some risk factors like Fever, Bruise, etc but they can be easily tackled with proper treatment.

Before commencing the surgical procedure, patients are advised to follow certain norms. These will aid in their preparation for the procedure. These are-

• Take a lighter meal or as advised by the doctor.
• Inform your medical professionals of the medications you are taking
• Bring your identification, insurance information, and any other documents required by the hospital
• Wearing comfy clothing
• Let your doctor about any recreational drug use you may have, including marijuana, alcohol, nicotine, etc

Summary: The patient needs to go through some simple steps before pilonidal sinus surgery.

Pilonidal sinus surgery is carried out by following some distinct steps. Different categories of surgery comprise different steps too. They involve the use of various medical equipment. They aim to remove the sinus along with the infected area. It can be done with or without sutures, as stated below-

The cost of pilonidal sinus surgery usually ranges from 40,000 to 55,000 rupees across various cities in India. Its cost gets influenced by a number of factors, such as the facility, the type of surgery being performed, other underlying disorders, the price of the medicines, and some specific tests to pre or post-operative procedures.

We need to follow some aftercare steps after a couple of hours of receiving your pilonidal sinus surgery. Some activities that take care of the surgical wound include:-

• Take proper rest.
• Alter bathroom habits.
• Keep your wounds clean.
• Put on comfortable clothes.
• Avoid strenuous activities.
• Keep your anal region clean after passing stool.
• Avoid extended periods of seating.
• Consume nutritious foods to soften your stools.

After pilonidal sinus surgery, doctors assign some dietary tips to fasten the healing process. We may include these foods in our diet to combat the symptoms:-

• Foods high in protein: Pulses, peas, beans, soybeans, cottage cheese, and almonds are some common examples.
• High-fiber foods: Fiber-rich foods such as fruits and vegetables aids digestion. Good sources of dietary fiber include apples, pears, bananas, carrots, oats, sweet potatoes, beets, etc.
• Garlic: Both antibacterial and antifungal activities are present.
• Turmeric: Curcumin present in turmeric improves your body's capacity to heal itself.
• Honey: honey is regarded as a superfood as it contains various nutrients.

Summary: To promote a healthy body and lower the risk of infections post pilonidal sinus surgery, the above-stated foods must be incorporated.

Yes, pilonidal sinus surgery is considered safe because it is minimally invasive and takes less time to complete. Patients can take discharged same day from the hospital. Only a doctor with experience should perform it. 

The pilonidal sinus is considered a little painful. However, it can be tackled by medications or other processes. Surgery is commenced after the insertion of anesthesia. It helps to lessen surgery-related pain and discomfort.

The recovery phase varies to a greater extent in different patients. However, a patient can resume their normal lifecycle after some days. Almost 4-5 weeks are required for complete recovery from pilonidal sinus surgery.

Some of the side effects are often accompanied by pilonidal sinus surgery. Possible negative effects include:

• Persistent ache
• Scar
• Bleeding
• Delayed healing
• Numbness
• Blood clots
• Certain Infections

After the completion of Pilonidal sinus surgery, post-surgical care is very important. They help to prevent the infection as well as the recurrence of the disorder. However, different surgical procedures require different types of care, such as:

Stitched wound

• Take a warm bath
• soak the wound daily
• Avoid using soap, salt, or other fragrant goods in the water until the wound gets completely healed
• change the dressing if your wound gets wet

Open wound

• Keep the area dry
• get the wound examined regularly

Here are also some general aftercare tips that are to be followed irrespective of the method of treatment:-

• It is advised to eat a diet rich in fiber to help with bowel motions.
• drink enough water
• limit your coffee and alcohol intake
• Try to maintain hair-free skin
• Be regular on follow-ups.

Pilonidal sinus is an irritating and painful disorder that highly impacts the well-being of the patient. It is crucial to eliminate it using medical means. Pilonidal sinus surgery is a potential way to treat this disorder. There are various types of pilonidal sinus surgeries are available out there.