Mark Said:

Is surgery compulsory for pilonidal sinus disease ?

We Answered:

It is universally agreed that the most effective emergency management of a pilonidal abscess is simple incision and drainage. However, surgical management of chronic and recurrent disease is more controversial. The majority of procedures can be classified in one of the four categories below:

Incision and drainage

Excision and healing by secondary intention

Excision and primary closure

Excision with reconstructive flap techniques.

Incision and drainage: This is a simple procedure

Incision and drainage: This is a simple procedure that involves making an elliptical incision in the abscess just off the midline. The mouth of the wound should be of sufficient width to allow packing of the entire wound cavity. Curettage to remove dead or infected tissue in the wound improves the rate of healing, with 90% completely healed at one month, compared to just 58% healed at 10 weeks in the absence of curettage.

Following a single incision and drainage procedure, 40-60% will go on to develop a PNS requiring further surgery. Pits or sinuses can be excised as part of an incision and drainage procedure, but these can be obscured by oedema and are often overlooked at the initial assessment. The recurrence rate can be reduced to about 15% if a second procedure to excise pits and sinuses is performed after five to seven days.

Healing by secondary intention has the advantage of allowing free drainage of infected material and debris. However the patient will require regular wound care and the discomfort of packing until the wound has closed. In a retrospective study mean number of days off work following incision and drainage was 20.

Wide excision and healing by secondary intention: Wide excision of an elliptical wedge of skin and subcutaneous tissue down to the pre-sacral fascia is designed to remove all the inflamed tissue and debris allowing the wound to granulate from its base. The excised dimensions should be of sufficient width at both the mouth and base of the wound to allow packing with ease. The base itself should be relatively flat and of almost comparable size to the mouth of the wound. A narrow V-shaped wound without a flat base is more difficult to pack and has a tendency to bridging and subsequent infection.

The procedure necessitates general anaesthesia and hospital stay for a few days postoperatively. The principal advantage is a low recurrence rate but the downside is a lengthy healing time (8-10 weeks) and high direct and indirect costs associated with inpatient care, follow-up wound care and days lost from work. Despite this there is a role for wide excision in those with extensive chronic disease and following failed primary closure surgical technique.
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The following article has more information you may find helpful in making an informed decision for best treatment:
http://www.worldwidewounds.com/2003/dece…

Audrey Said:

is it possible to cure pilonidal sinus succesfully by performing keyhole surgery?

We Answered:

Get pilonidal sinus surgery in india.
Medical treatment and Surgery is very cheap in India.There is one company that is very famous in India that arranges all types of surgery for foreigners in India.They are called the Forerunners Healthcare.I read a lot about them in the Newspapers and about their patient stories.

I have also read that they arrange financing for american and canadian patients as all types of medical treatment and surgery is not covered by insurance.They also have photos pasted of their International patients.You can checkout their website.The cost savings are incredible.

As a doctor i personally believe that your medical treatment and surgery can be easily handled in India as the quality of healthcare available here is simply best in the world.The surgeons are USA/UK trained and facilities are 5 star.


my cousin got her knee joint replacement surgery and gastric bypass surgery in India through the forerunners healthcare.she is more than very happy with the results.she just paid 30% of the amount she was quoted in USA and is all praise fore this forerunners healthcare company.i personally have seen the wondeful results and am particularly impressed with the kind of quality care she got from this company.hope this helps.

Source(s):
http://www.forerunnershealthcare.com

Kathleen Said:

Pilonidal sinus surgery?

We Answered:

There are actually quite a few different procedures used to treat pilonidal sinuses but all of the treatments involve removing the ‘pits’ where hairs get stuck and cause infection. Occasionally, the sinus is very small and can be completely removed followed by closure of the skin with stitches (which are later removed). More often, it is necessary to leave an open wound; the edges of the wound may be partly closed with an absorbable stitch.

Special dressings are sometimes used to pack the wound. These will be changed daily by a District Nurse when you go home.

Bernice Said:

Are there other treatments for pilonidal sinus other than surgery?

We Answered:

Go to mayoclinic.com, then "diseases and conditions." the letter "p" and then pilonidal cyst. It will tell you what causes it, symptoms, much more.

Treatments and drugs
By Mayo Clinic staff
Treatment for an infected pilonidal cyst may include:

Incision and drainage
The initial treatment for an infected pilonidal cyst, or pilonidal abscess, is usually a procedure performed by your primary care doctor or a surgeon. You're given a local anesthetic to numb the area before your doctor opens the abscess, drains the fluids and removes hair and other debris. The wound is packed with dressing so that it can heal from the inside out. For about 50 to 60 percent of people with an infected pilonidal cyst, this treatment is effective and no further treatment is needed.

Surgery
A surgical procedure is necessary if you have a recurring infected pilonidal cyst or if one or more sinus tracts are present. A surgeon will expose the cysts and all sinus tracts in order to clean out hairs, pus and other debris. The preferred surgical procedures generally fall into two categories:

Open wound. The surgical wound is left open and packed with dressing to allow it to heal from the inside out. This process results in a longer healing time but usually a lower risk of a recurring pilonidal cyst infection.
Closed wound. After cleaning out the cyst and sinus tracts, the surgeon stitches the wound closed. The healing time is shorter with these procedures, but there is a greater risk of recurrence. To improve healing time and lower the risk of recurrence, the surgeon may make the incision off to one side and create a flap of skin. Therefore, when he or she stitches the wound, it is not in the cleft of the buttocks, where healing is particularly difficult.
Wound care is extremely important after surgery. Your doctor or nurse will give you detailed instructions on how to change dressings, what to expect of a normal healing process and when to call the doctor. Postoperative care will also include shaving around the surgical site to prevent hairs from entering the wound.

Violet Said:

Surgery for pilonidal sinus in Bangalore?

We Answered:

Anyway you have been diagnosed to have "Pilonidal Sinus"
This can Only been done by your Doctor,
as yourself cannot even see what it is .

If the diagnosis is Correct,nowadays it is one of the
Simple Surgeries which Can be undertaken by
any good Surgeon/Pvt. hospitals too.

Prefer to get it done properly in a Medical College
hospital.
Many are there in Bangalore.

Need not be Surgeon Specific.
St. John's MCH etc., are very good.,
so also KIMS.

If prefer Pvt you Can seek expert advise from your own
Family Doctor.