Anal fissures Anal fistulas Bowel cancer Bowel polyps Colostomy Diverticular diseaseHaemorrhoids (piles) Internal sphincterotomy Loop ileostomy Major bowel surgery Minor anorectal surgery Pilonidal sinusPruritus ani (anal itchiness)

What is pilonidal sinus surgery?

A pilonidal sinus is a condition where there are one or more pits at the base of the spine. Hairs collect in these pits and cause irritation, often leading to abscess formation. Surgery is required if abscesses form, or if there are symptoms such as pain and discharge.

 

 

 

What does surgery involve?

• Shaving: The area will be shaved for you just before your operation (there is no need to do this yourself).
  
  

• Anaesthetic: Several different kinds of anaesthesia can be used, and the method will be tailored to your particular needs and wishes. If you have general anaesthesia, you will be asleep for the entire procedure. Many patients who undergo day-case surgery or 23-hour-stay surgery will not require a general anaesthetic. Instead, controlled sedation and the injection of local anaesthetic can allow the operation to be performed painlessly and with a fast recovery. Most patients who have had sedation do not remember the surgery taking place.
  
  

• Surgery: Pilonidal sinuses can be treated in several different ways, all of which remove the ‘pits’ in which hairs get stuck and cause infection. Occasionally, if the sinus is very small, it can be completely removed and the skin closed with stitches (sutures, which are later removed). More often, it is necessary to leave an open wound; the edges of the wound might be partly closed with an absorbable stitch. Special dressings are not normally required, but a gauze pad will help to protect clothing from any discharge.

 

 

What will happen after the operation?

Within one to two hours of your operation, you will be encouraged to get up and walk around. You will be allowed home from hospital on the same day (for planned day-case surgery) or the following day. You will be given some painkillers to be taken by mouth as required. A small amount of bleeding or discharge is expected. You should be able to resume normal daily activities rapidly. Provided you feel comfortable, you may lift things, drive and go back to work. You should, however, avoid contact sports or other activities that might disrupt the stitches during the first two to four weeks.

 

 

 

How should I look after the wound?

If the wound has been sutured closed, then you should keep it dry for at least five days to minimise the risk of infection getting inside. Wounds that are left open to heal, however, benefit from regular (at least once a day) cleaning with a shower spray or in the bath. In order to prevent recurrence of the sinus, the area around the wound should be kept free of hairs by weekly shaving.

 

 

 

What can go wrong?

Surgical treatment of pilonidal sinus is generally very safe and is associated with few risks, but, as with any surgical procedure, complications can occur occasionally. Therefore, after your operation you should contact your general practitioner, our Specialist Colorectal Nurse or the ward staff if you notice (a) severe bleeding or (b) increasing pain, redness, swelling or discharge, which might indicate there is an infection.

 

 

 

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