Pilonidal Sinus Treatment in Dubai
Understanding
Pilonidal Sinus and Pilonidal Cyst
Pilonidal sinus (PNS) is a condition characterized by a small tunnel or hole in the skin, often filling with fluid or pus, leading to the formation of a cyst or abscess. Typically found in the cleft at the top of the buttocks.
It starts with a cyst- that forms with hair, dirt, and debris. If it is not cured, it becomes an abscess- a pus, or fluid-filled cyst. When the treatment is delayed, the condition develops into a small tunnel called the Pilonidal sinus.
Conditions and Treatment
Quick Enquiry
What’s The Difference?
Cyst- Cyst is a sac filled in with different material, liquid or solid. They are of varied types and sizes.
Abscess– Is a subcutaneous localized infection. It can happen when the content of a cyst develops an infection, sometimes the cyst was not evident before the infection and remains patent after the infection is solved.
Pilonidal sinus- A pilonidal sinus is a cyst originated in a hair follicle (small pit or pore in skin containing dark spots or hair). It is usually located in between the buttocks .
PNS can be painful and discomforting.
Pilonidal sinus (PNS) typically affects the inter-gluteal region between the buttocks (natal cleft) over the sacrum (the base of the spine) and the coccyx (commonly referred to as the tailbone).
Also read: How To Cure Pilonidal Cyst?
Common Signs and Symptoms of Pilonidal Sinus
At first, you may notice a small dimple-like depression on your skin’s surface. However, when infected, it quickly progresses into a cyst or abscess.
Signs of infection include pain while sitting or standing, swelling, reddened and sore skin, pus or blood discharge with a bad odor, and protruding hair from the lesion. In some cases, multiple sinus tracts may form.
Causes of Pilonidal Sinus
Pilonidal cysts are primarily caused by trapped groups of hairs and debris in the pores of the skin in the upper buttock cleft, leading to abscess formation.
The risk factors include being :
- male
- having thick body hair
- Long periods of sitting position (office work, drivers…)
- sedentary habits
- family history
- being overweight
- and previous occurrences.
Pilonidal Sinus Treatment in Dubai
Treatment depends on the extent of the condition and whether it’s a recurring issue or a first-time occurrence. For infected pilonidal abscesses, pus drainage and, sometimes, antibiotic treatment are needed. For non-infected cases (or after the infection is controlled with drainage) surgery is highly recommended, as it is the only way to avoid further complications and even the development of new tunnel branches that will make further treatment more challenging.
Surgical Options
- Incision & Drainage: This involves creating a small hole in the abscess to drain pus. Just for infected cases.
- Excision and Open Healing: Removal of the sinus with the surrounding skin, allowing natural healing. This option is the “old-school” treatment and should never be recommended, as it can take up to 2-5 months to heal, requiring daily specialized (nurse or surgeon) dressing
- Excision and Direct Wound Closure: The sinus is removed, and skin edges are stitched together. This option involves a high rate of failure, with reopening of the suture and relapse of the sinus. It’s therefore not recommended.
- Excision and Flap Wound Closure: this is widely recognized as the best option for PNS, providing both a fast recovery and a low rate of disease relapse. There are several options:
- The cleft lift flap (AKA Karydakis modified flap or Bascom Flap). This technique can address both simple and complex cases but necessitates specific training for precise execution. It entails asymmetrical resection to flatten the natal cleft and relocate the surgical suture. A flap is created from the medial edge to cover the gap/defect and close the wound, effectively avoiding the intergluteal cleft. It modifies the buttock crease to prevent hair and debris accumulation, a common contributor to pilonidal disease and ongoing infections. Importantly, this surgical method involves suturing the wound closed, eliminating the need for ongoing dressing changes.
- Limberg Flap, Z-plasty and other flaps: these are very complex techniques that have important aesthetic consequences for the patients and are reserved for recidivated cases in which other techniques have failed
- Endoscopic Treatment for Pilonidal Sinus (EPSIT): A minimally invasive technique involving the use of an endoscope to remove hair and infected tissue, followed by heat or laser sealing of the sinus. This is a promising but not yet verified technique as there are not enough studies/cases to assure the long-term results.
- GIPS: It is a surgical treatment option for pilonidal sinus. It involves the removal only of the individual pits and tunnels. GIPS is typically suggested for mild cases or as a preventive measure.
- Laser Treatment for Pilonidal Sinus: Laser treatment for pilonidal sinus is a minimally invasive process that uses laser energy to remove infected tissue and seal the sinus tract. It’s often recommended for patients with recurrent or persistent pilonidal sinus issues, providing a less invasive alternative to traditional surgical methods. As with the EPSIT procedure, this is a promising but not yet verified technique as there are not enough studies/cases to assure the long term results
Recovery Period:
Recovery time depends on the procedure but is typically short. Most individuals can return to work within a few days post-surgery. Maintaining proper hygiene and wearing comfortable clothing. Following post-operative care instructions is essential for a smooth recovery.
Pilonidal treatment is like 50% surgery and 50% aftercare!
Proper wound care is essential for post-pilonidal surgery recovery.
- Clean the surgical site as per your surgeon’s instructions, avoiding harsh scrubbing.
- Change dressings regularly to maintain cleanliness.
- Manage pain with prescribed medications to aid comfort and mobility.
- Gradually increase activity as advised, avoiding strenuous activities.
- Maintain a balanced diet including leafy vegetables, legumes and fiber and stay hydrated for proper healing.
- Watch for signs of infection like increased pain, swelling, warmth, redness, or drainage.
- Monitor for a persistent fever, which could indicate complications.
- Be alert to wound dehiscence (opening up) and report it promptly.
- Report any purulent or foul-smelling discharge from the wound.
- Consult your surgeon if wound healing seems delayed.
Note: Remember that scar remodeling can continue for up to a year, and irritation may occur.
Meticulous wound care and prompt reporting of red flags are vital for pilonidal surgery aftercare. Follow your surgeon’s guidance for a successful recovery.
Pilonidal Sinus Surgery Cost in Dubai:
The cost of pilonidal sinus surgery in Dubai varies depending on the specific procedure and your individual requirements. Dr. Daniel Serralta de Colsa has broad experience in advanced laparoscopic surgery and offers competitive pricing for these treatments. During your consultation, a detailed cost estimate is provided based on your unique case.
Consult Dr. Daniel Serralta to experience safe and effective pilonidal sinus treatment in Dubai.
Interesting FAQs about Pilonidal Sinus
Most cases involve a painful lump in the tailbone area that moves when pressed. Not all cases have an obvious lump; some present with draining sinuses.
Only a doctor can provide the right diagnosis, as Pilonidal Disease presents differently in individuals. Common symptoms include discomfort around the tailbone, swelling, and the presence of a lump.
Pilonidal Disease often results from “follicular occlusion,” caused by stretched pores in the tailbone area due to friction and pressure when sitting. While some doctors still consider it congenital, it’s essential to consult a knowledgeable physician for the latest information.
Being overweight can contribute to Pilonidal Disease, especially if it deepens the natal cleft (buttock crease), trapping more moisture and debris and increasing pressure.
Pilonidal Disease rarely becomes cancerous. Surgery often includes a tissue test to rule out any malignancy.
Pilonidals typically occur in the buttock cleft area, but similar abscesses may appear in other regions like the umbilicus, breast, pubic area, or armpit, indicating different conditions like Hidradenitis Suppurativa.
Infections are marked by severe pain, difficulty in movement, and foul-smelling drainage from a sinus, which may vary in color.
Diagnosis typically relies on symptoms, but high-resolution MRI with contrast or ultrasound may be used in some cases for visualization.
