Pilonidal cyst

Question 1

What is a pilonidal sinus?

Answer 1

Pilonidal sinus is caused by the forceful insertion of hairs into the skin of the natal cleft in the sacrococcygeal area.

Question 2

What are the risk factors of a pilonidal sinus?

Answer 2

> Male
Age 16-40
FHx
Stiff hair and hirsutism

Question 3

What is the epidemiology of pilonidal sinuses?

Answer 3

Pilonidal sinus is common, with an estimated prevalence of 26 cases per 100,000 population in the US.

Question 4

What are the signs and symptoms of a pilonidal sinus?

Answer 4

> Discharge 
> Pain and swelling
> Sinus tracts
> Skin maceration
> Natal cleft pain and swelling
> Fever or toxaemia

Question 5

What investigations would you do for a pilonidal sinus?

Answer 5

Clinical

Question 6

What is the management of a pilonidal sinus?

Answer 6

Hair removal
Local hygiene
Antibiotic therapy
Surgical treatment
Analgesia

Question 7

What are the complications of a pilonidal sinus?

Answer 7

> suppurative, post-operative collection deep to sutures

> Necrotising fasciitis

Question 8

What is the prognosis of a pilonidal sinus?

Answer 8

Depending on the surgical technique chosen, recurrence rates are variable and average 6.9%. Recurrence is less likely to occur after healing by secondary intention compared with any type of primary wound closure, although off-midline closure confers an advantage over midline techniques