Pilonidal Sinus Disease

Question 1

What is pilonidal sinus disease

Answer 1

disease of the inter-gluteal region*, characterised by the formation of a sinus in the cleft of the buttocks

Question 2

Which group of people does this most commonly affect

Answer 2

males aged 16-30 years .

Question 3

what is the pathophysiology of pilonidal sinus disease

Answer 3

hair follicle in the intergluteal cleft becoming infected or inflamed.

The inflammation obstructs the opening of the follicle which therefore means that the hair follicle extends inwards forming a pit.

A foreign body type reactions may then occur leading to the formation of a cavity

Question 4

What are the risk factors of getting pilonidal sinus disease

Answer 4

Caucasian males 
Coarse dark body hair 
Sitting for long periods of time 
Increased friction in buttock
Poor hygiene
Increased sweating

Question 5

What are the clinical features of pilonidal sinus disease

Answer 5

intermittent red, painful, and swollen mass in the sacrococcygeal region.

Discharge

Question 6

How can you differentiate between a perianal fistula and pilonidal sinus disease

Answer 6

pilonidal sinus opens up onto the skin, but does not communicate with the anal canal like perianal fistula does

Question 7

What is the non-surgical management of pilonidal sinus disease

Answer 7

Shaving affected region

Pluck the sinus free of any hair

Maintain personal hygiene

Question 8

What is the surgical management for acute pilonidal sinus disease

Answer 8

Incision and drainage with washout

Question 9

What is the surgical management for chronic pilonidal sinus disease

Answer 9

There are two main methods:

1. excising the tract and laying open the wound, allowing closure by secondary intention
2. excising the tract, followed by primary closure of the wound