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A Pilonidal sinus 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 buttocks (sacrococcygeal region). A Pilonidal sinus usually contains hair and debris. The name Pilonidal is taken from Latin meaning โ๐๐๐๐ ๐๐ ๐๐๐๐๐”. It can cause severe pain or become infected. It may ooze pus or blood and have a foul odor. It mostly affects men and common in young adults. It is more common in people who sit for long time, like drivers.
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It is caused by a combination of changing hormones (puberty), excessive hair growth and friction from clothes or spending long time sitting.
Activities causing friction force the hair growing in the area to burrow back under the skin.
๐๐จ๐ฐ ๐ญ๐จ ๐ข๐๐๐ง๐ญ๐ข๐๐ฒ ๐ ๐๐ข๐ฅ๐จ๐ง๐ข๐๐๐ฅ ๐ฌ๐ข๐ง๐ฎ๐ฌ?
There may be just a small dimple like depression on the surface of the skin of lower back in the natal cleft. It becomes symptomatic when infected.
The signs of infection include :
โข Pain when sitting or standing
โข Swelling of cyst
โข Reddened or sore skin around the area
โข Pus or blood draining from the abscess causing a foul odour
โข Hair protruding from the lesion
โข Formation of more than one sinus tract, or holes in the skin
๐๐ข๐ฅ๐จ๐ง๐ข๐๐๐ฅ ๐ฌ๐ข๐ง๐ฎ๐ฌ ๐ข๐ฌ ๐ฆ๐จ๐ซ๐ ๐๐จ๐ฆ๐ฆ๐จ๐ง๐ฅ๐ฒ ๐๐จ๐ฎ๐ง๐ ๐ข๐ง ๐ฉ๐๐ซ๐ฌ๐จ๐ง๐ฌ ๐ฐ๐ข๐ญ๐ก:
โข Excessive, coarse, curly or crinkly hair
โข Deep natal cleft
โข Poor hygiene
โข Obesity
โข Family predisposition
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The most definite treatment for Pilonidal sinus is surgery.
If there is infection antibiotics can be given. This wonโt heal the sinus-tract, but will give relief from the infection and discomfort.
It is recommended to regularly remove hair by clipping or shaving the site and maintain good hygiene.
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There are numerous procedures described to treat this condition. The most successful procedure with least recurrence is Limberg flap.
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This technique involves wide excision of the area and closing a 60 degree rhombus-shaped defect with a transposition flap. This flap takes the suture line away from midline giving rise to tension free flap of unscarred skin in the midline, which helps in maintenance of wgood hygiene, reduced sweating, maceration, erosion and scar formation. It is superior to primary closure or other flap procedures and a safe & reliable method with low complication and recurrence rate.
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โข The patients get immense relief from the weeping and swollen bottom
โข There is no distortion of the contour of the bottom
โข This technique is easy to perform in quick time
โข Very low complication rate and recurrence
โข Quick healing time
โข Short hospital stay
โข Early return to work and daily activities
๐๐จ๐ฌ๐ญ๐จ๐ฉ๐๐ซ๐๐ญ๐ข๐ฏ๐ ๐ฉ๐ซ๐๐๐๐ฎ๐ญ๐ข๐จ๐ง
Avoid pressure on flap for 3 weeks
๐๐จ๐ฐ ๐ญ๐จ ๐ฉ๐ซ๐๐ฏ๐๐ง๐ญ ๐๐ข๐ฅ๐จ๐ง๐ข๐๐๐ฅ ๐๐ข๐ง๐ฎ๐ฌ?
โข Washing the area on a daily basis with a mild soap, making sure all soap is removed
โข Keeping the area completely dry
โข Avoid sitting continuously for long periods
๐๐จ๐ฎ ๐๐๐ง ๐ฐ๐๐ญ๐๐ก ๐ ๐ฏ๐ข๐๐๐จ ๐จ๐ ๐๐ข๐ฆ๐๐๐ซ๐ ๐๐ฅ๐๐ฉ ๐ฉ๐๐ซ๐๐จ๐ซ๐ฆ๐๐ ๐ข๐ง ๐ ๐ฉ๐๐ญ๐ข๐๐ง๐ญ ๐จ๐ ๐๐ข๐ฅ๐จ๐ง๐ข๐๐๐ฅ ๐ฌ๐ข๐ง๐ฎ๐ฌ ๐๐ฒ ๐๐ซ๐จ๐๐๐ฌ๐ฌ๐จ๐ซ ๐๐ซ ๐๐ญ๐ฎ๐ฅ ๐๐ข๐ฌ๐๐ก๐ซ๐ ๐๐ญ ๐จ๐ฎ๐ซ ๐๐จ๐ฎ ๐๐ฎ๐๐ ๐๐ก๐๐ง๐ง๐๐ฅ