Does congenital pilonidal sinus need surgery?

summary

Pilonidal sinus and pilonidal cyst are collectively referred to as pilonidal disease, which is a kind of chronic sinus or cyst in the soft tissue of sacrococcygeal gluteal fissure. It can also be manifested as acute abscess of sacrococcygeal region, forming chronic sinus after perforation, or temporary healing, and finally perforation, which can occur repeatedly. Does congenital pilonidal sinus need surgery? Let's talk about it

Does congenital pilonidal sinus need surgery?

All the diseased tissues, free muscles and skin were excised and the wound was completely sutured for primary healing. In order to eliminate the deep gluteal fissure and its negative pressure, reduce wound dehiscence, hematoma and abscess, Z-plasty is feasible (Fig. 1). It is suitable for cysts and small non infected sinuses on the midline, with a recurrence rate of 0% - 37%. It has the advantages of short healing time, soft scar formed in the gluteal fissure, soft tissue between the scar and sacrum, and can tolerate injury.

The skin on both sides of the wound was sutured with the sacral fascia, so that most of the wounds were healed at the first stage, and the middle part of the wounds were healed by granulation tissue. It is suitable for the cases with many ostium and sinus tract. The effect is the same as that of primary suture, but the healing time is longer. 3. The secondary suture is suitable for severe infection and primary suture for incision and drainage of infected wound.

The surface of the sinus wall and the skin of the upper cover were excised by bag suture, and the wound was healed by catgut or absorbable artificial suture. Careful postoperative care, often can see satisfactory results. Most of them are used for unresectable cases or recurrent pilonidal sinus.

matters needing attention

If the wound can be closed, it will need to be kept clean and dry until the skin is fully healed. If the wound has to be suspended, dressings or packaging will need to help remove secretions and allow the wound to heal from the bottom up.