Pilonidal Sinus Flashcards
Define Pilonidal Sinus?
An abnormal epithelium-lined tract filled with hair that opens onto the skin surface, most commonly in the natal cleft
What is the aetiology of Pilonidal Sinus?
Caused by shed or sheared hairs penetrating the skin and inciting and inflammatory reaction and sinus development
Intermittent negative pressure will draw in more hair and perpetuate the cycle
What are the risk factors for Pilonidal Sinus?
Hirsuitism
Spending a long time sitting down
Occupational (e.g. hairdressers may develop interdigital Pilonidal Sinus)
What is the epidemiology of Pilonidal Sinus?
COMMON
Affects 0.7% of young adults
What are the presenting symptoms of Pilonidal Sinus?
Painful natal cleft
Discharging swelling
Often recurrent
What are the signs of Pilonidal Sinus on physical examination?
Midline openings or pits between the buttocks
Hairs may protrude from the swelling
If infection or abscess, the swelling will become tender
It may be fluctuant and discharge pus or blood-stainined fluid on compression
What investigations do we do for Pilonidal Sinus?
None needed
Why might we do bloods for Pilonidal Sinus?
To check for signs of infection
What bloods might we do for Pilonidal Sinus?
Raised WCC Fasting Glucose (diabetics are at risk)
What is the management plan for Acute Pilonidal Abscess?
Inicison and Drainage
What is the management plan for Chronic Pilonidal Sinus?
Excision under general anaesthesia with exploration
How do we prevent Pilonidal Sinus?
Good hygeine
Shaving
What are the possible complications of Pilonidal Sinus?
Pain
Infection
Abscess
Recurrence
What is the prognosis for patients with Pilonidal Sinus?
Good with drainage
Shaving will cure in most cases
Usually resolves by the age of 40
