Pilonidal sinus Flashcards
define a pilonidal sinus?
an abnormal epithelium-lined tract filled with hair that opens onto the skin surface, most commonly in the natal cleft
what are the risk factors of a 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
- Eventually an abscess forms
risk factors of pilonidal sinuses?
o Hirsutism
o Spending a long time sitting down
o Occupational e.g. hairdressers may develop interdigital pilonidal sinus)
epidemiology of pilonidal sinus?
- Affects 0.7% of young adults
- More common in men after puberty
- More common in Caucasians
presenting symptoms of pilonidal sinuses?
- Painful natal cleft
- Discharging swelling
- Can present with an abscess
- Cycles of being asymptomatic and periods of pain and discharge
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-stained fluid on compression
investigations for pilonidal sinuses?
• NONE needed
• Bloods - to check for signs of infection
o Raised WCC
o Fasting glucose (diabetics are at risk)
management for abscess?
o antibiotics Incision and drainage
management for pilonidal sinuses?
• Bascom procedure
o Excision of pits and destruction of the underlying cavity.
• Karydakis procedure
o Involves wide excision of the natal cleft
how to prevent pilonidal sinuses?
o Good hygiene
o Shaving
complications of pilonidal sinuses?
- Pain
- Infection
- Abscess
- Recurrence
what is the prognosis for patients with a pilonidal sinus?
- Good with drainage
- Shaving will cure in most cases
- Usually resolves by the age of 40
