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A pilonidal sinus starts as a small abscess under the skin at the top of the buttocks. If left untreated, the symptoms of a pilonidal sinus can be acute or chronic, causing distress and pain to those affected.
A pilonidal abscess is an abscess created by pilonidal sinus disease. This is an inflammatory condition that commonly affects teenagers and young adults, usually males. It is typically seen in the natal cleft or gluteal fold which sits at the top of the buttocks. The basic elements involved in the condition are hairs, midline pits in the natal cleft, and a foreign body reaction to the hairs in the pits and sinuses.
This hair debris can lead to inflammation and infection in the area, and possibly abscess formation. The condition can span over the course of many years, to varying degrees.
Traditionally pilonidal sinus disease has been treated with surgery to drain abscesses or excise the affected area; however, this can result in significant wounds that can take months to heal if left open and can reoccur post-surgery. Patients can be left with wounds that can take months to heal, sometimes with dressings that require daily changing.
Instead, we typically utilise a new keyhole surgery technique that does not create large wounds requiring intensive wound management with dressings. This is known as Endoscopic Pilonidal Sinus Surgery.
At Brisbane General & Obesity Surgery, we will always advise you on the most appropriate treatment for your needs, whether that is surgery or another option. We’ll explain the pilonidal sinus surgery options available and can advise you on the most appropriate treatment for you.
Endoscopic Pilonidal Sinus Treatment – also known as EPSiT – is a new minimally-invasive treatment for pilonidal sinus disease. It involves using the midline pits that are already present. Therefore it does not create large wounds that can take months to heal. A fine rigid endoscope is used to look inside the pits and sinuses and any hair and debris inside are extracted. Granulation tissue is cauterised and dead tissue is removed.
No packing of wounds is typically required, and there is no requirement for daily dressings of wounds. This means less pain, a faster return to work and a high rate of healing with minimal wound care required. If the problem recurs, this minimally invasive technique can be used again.
A pilonidal sinus surgery is performed as day surgery. You will go home on the same day as surgery and require a carer to stay with you. The only dressing requirement will be an absorbent pad in your underwear. A lady’s sanitary pad is usually all that is required for a few days. You will then need to visit our Outpatient Clinic six weeks after surgery.
When a pilonidal sinus abscess is present, the condition needs to be treated quickly with pilonidal abscess surgery.
Dr Wong has developed a technique using EPSiT to treat pilonidal abscesses which does not require daily formal dressings or packing. In his experience, healing rates have been equivalent to elective cases.
If you need pilonidal sinus surgery, we can assist you. Book a consultation with us to get started. However, if you are experiencing serious pain or have any major concerns, we recommend you see a doctor or contact us as soon as possible so we can assess your case.
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