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Pilonidal sinus treatment in Iran

Pilonidal sinus treatment in Iran

What is pilonidal sinus disease (PNS)?

A pilonidal sinus (PNS) is a small hole or tunnel in the skin. It may fill with fluid or pus, causing the formation of a cyst or abscess. It occurs in the cleft at the top of the buttocks. A pilonidal cyst usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. If it becomes infected, it may ooze pus and blood and have a foul odor.

A PNS is a condition that mostly affects men and is also common in young adults. It’s also more common in people who sit a lot, like cab drivers.

Causes

What are the causes of pilonidal sinus disease?

The exact cause of this condition isn’t known, but its cause is believed to be a combination of changing hormones (because it occurs after puberty), hair growth, and friction from clothes or from spending a long time sitting.

Activities that cause friction, like sitting, can force the hair growing in the area to burrow back under the skin. The body considers this hair foreign and launches an immune response against it, similar to how it would react when dealing with a splinter. This immune response forms the cyst around your hair. Sometimes a person may have multiple sinuses that connect under the skin.

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Signs and symptoms

You may not have any noticeable symptoms at first other than a small, dimple-like depression on the surface of your skin. However, once the depression becomes infected, it will quickly develop into a cyst (a closed sac filled with fluid) or an abscess (a swollen and inflamed tissue where pus collects).

The signs of an infection include:

. Pain when sitting or standing

. Swelling of the cyst

. Reddened, sore skin around the area

. Pus or blood draining from the abscess, causing a foul odor

. Hair protruding from the lesion

. Formation of more than one sinus tract, or holes in the skin

You may also experience a low-grade fever, but this is much less common.

Risk factors

Certain factors can make you more susceptible to developing pilonidal cysts, such as:

. Male sex

. Younger age (pilonidal cysts are most common in people in their 20s)

. Obesity

. Inactive lifestyle

. Occupation requiring prolonged sitting

. Excess body hair

. Stiff or coarse hair

Treatment

A pilonidal sinus that's not infected

Treatment is not needed if there are no signs of infection. A "watch and wait" approach will be recommended.

It's very important to keep the area between your buttocks clean by showering or bathing regularly.

Do not shave the affected area unless a GP advises you to.

Treatments for an infected pilonidal sinus

Treatment for an infected pilonidal sinus will depend on:

. Your symptoms

. The size of the sinus

. Whether it's your first sinus or it keeps coming back

A pilonidal sinus abscess will need treatment with antibiotics. The pus inside will also probably need to be drained.

There are a number of treatment options for a pilonidal sinus that keeps coming back and that's painful, bleeding or leaking discharge. Your doctor will discuss these with you.

In most cases you'll be offered painkillers, such as paracetamol and anti-inflammatories to help reduce pain and swelling.

Minor operation to drain pus from sinus

Incision and drainage

Hospital procedure for an uncomplicated abscess. A small hole is made in the abscess so the pus can be drained.

. General anesthetic or local anesthetic, depending on the size of the abscess

. Hospital stay (you can leave the same day)

. Regular (daily) dressing changes

. Recovery time is 4 to 6 weeks

Surgery to remove sinus (wound left open)

Wide excision and open healing

Surgery for a large or repeatedly infected sinus. The sinus is cut out and some surrounding skin removed. The wound is left open to heal naturally.

. General anesthetic

. Hospital stay (you can usually leave the same day)

. Regular (daily) dressing changes

. Lowest risk of sinus coming back

. Recovery time is 6 to 12 weeks

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Surgery to remove sinus (wound closed)

Excision and wound closure, often with flattening of the groove between the buttocks.

Surgery for a large or repeatedly infected sinus. The sinus is removed and an oval-shaped flap of skin cut out on either side of it. The 2 sides are stitched together.

. General anesthetic

. Hospital stay (you can usually leave the same day)

. Stitches removed about 10 days after the operation

. Quicker recovery time than wide excision and open healing

. Higher risk of infection (the wound may need to be opened and dressings changed regularly).

Procedure to clean sinus and encourage healing

Endoscopic ablation for a pilonidal sinus

An endoscope (a thin, flexible tube with a camera on the end) is used to give a clear view of the affected area.

Hair and infected tissue are removed, and the sinus cleaned with a special solution. Heat is used to seal the sinus.

. Spinal or local anesthetic

. Hospital stay (you can usually leave the same day)

. Less invasive than surgery as no cut needed

. Good success rate with low risk of complications

. Recovery time is about a month to completely heal (but can be quicker)

Plastic surgery is sometimes used if the area being treated is particularly large. The sinus is removed and the surrounding skin reconstructed.

Less invasive procedures, like injection with fibrin glue, are also available in some places.

Complications

What complications are associated with pilonidal sinus disease?

There are a number of complications that may arise from PNS. These include wound infection and a recurrence of the PNS even after surgery.

Signs that the wound is infected include:

. Severe pain

. Inflamed, swollen skin

. A temperature of 100.4°F or higher

. Blood and pus seeping from the wound site

. A foul odor coming from the wound

Prevention

How can I prevent pilonidal sinus disease?

To help prevent pilonidal cysts, try to:

. Keep the area clean

. Lose weight if needed

. Avoid prolonged sitting

If you've had pilonidal cysts in the past, you might want to regularly shave the area or use hair removal products to reduce the risk of recurrence.

Recovery

How long does it take to recover from pilonidal cyst surgery?

After surgery, your physician might choose to leave the wound open or close it with stitches. The use of stitches may help you heal faster, but there’s a higher chance that your cyst will recur.

The amount of time it takes for you to recover depends on how your surgery was done and if you received stitches. In general, it’ll probably take anywhere from one to three months to completely heal.

Most people can resume their regular activities two to four weeks after surgery.

You may experience some pain or tenderness during the recovery process. This can be managed by:

. Taking pain medications prescribed by your doctor

. Avoiding strenuous activities

. Using a donut cushion to sit on

. Not sitting for long periods of time on hard surfaces

Your doctor will provide you with instructions on how to keep your wound clean. Follow these directions carefully to avoid an infection or recurrence.

If your doctor prescribes antibiotics, be sure to complete the full course, even if you start to feel better before they’re finished.

Call your healthcare provider if you experience:

. A fever

. Pus draining from your incision

. Increased pain, swelling, warmth, or redness near the incision

10 common question about Pilonidal sinus treatment

1How long does it take to recover from a pilonidal cyst surgery?
about 4 weeks If the cut (incision) was closed with stitches, it will probably take about 4 weeks to completely heal. If your incision is left open, it may take from a few weeks to several months to heal. After the incision has healed, you will have a scar where the cyst was removed. This will fade and become softer with time.
2Is a pilonidal cyst dangerous?
While the cyst is not serious, it can become an infection and should therefore be treated. When a pilonidal cyst gets infected, it forms an abscess, eventually draining pus through a sinus. The abscess causes pain, a foul smell, and drainage. This condition is not serious.
3Is pilonidal cyst surgery painful?
A tailbone cyst is also called a pilonidal cyst. ... The cyst may become painful and leak pus. This procedure may also be done even if a cyst isn't infected. The procedure can relieve pain caused by the cyst and keep it from getting infected.
4Will a pilonidal cyst go away by itself?
This problem will not go away by itself and will become worse over time. Furthermore, pilonidal cysts endanger your body and health and might lead to deadly blood infection. ... As long as the pilonidal cyst remains intact, expect recurrent infection, pain, drainage of copious pus, and tracking.
5How painful is a pilonidal cyst?
It's called a pilonidal cyst, and it can become infected and filled with pus. Once infected, the technical term is “pilonidal abscess,” and it can be painful. It looks like a large pimple at the bottom of your tailbone. ... If your cyst becomes a problem, your doctor can drain it or take it out through surgery.
6Is it painful to have a cyst removed?
If left untreated, a cyst can either perpetually grow or rupture and cause extreme pain. ... If you've never had a cyst removed before, don't worry – the procedure is typically fast and painless. The steps of cyst removal typically involve: Numbing – The doctor will use a lidocaine injection to numb the area.
7Can pilonidal cysts cause cancer?
Very occasionally, a form of skin cancer can develop in the cyst. Generally, the outlook for anyone with a pilonidal cyst is excellent, with a complete cure being possible. It must be remembered, however, that a pilonidal cyst may recur in anyone who has had one removed surgically.
8What happens if you dont treat a pilonidal cyst?
If not treated, this infection can lead to a cyst, and possibly into an abscess (pockets of infection) or a sinus (a cavity underneath the skin). Pilonidal disease usually first shows up as a swollen area or abscess with draining pus. This may then lead to a sinus.
9Can I pop a pilonidal cyst?
A pilonidal cyst can look similar to a pimple, tempting some to pop them with their fingers. But popping a pilonidal cyst won't fix the problem. Remember pilonidal cysts are filled with hair and other debris in addition to pus, and you won't be able to get it all out by squeezing.
10Can a pilonidal cyst return after surgery?
A complete cure is possible, but a pilonidal cyst can come back even if you had it surgically removed. Check for any signs of a new infection, like redness, pus, or pain.

 

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