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Management

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If a pilonidal sinus is small, then it may only require antibiotic treatment. If the sinus develops into an acutely inflamed abscess, then it will require drainage.

There are three alternative procedures that may be undertaken (1):

  • the lesion can be incised and laid open
  • the lesion can be completely excised
  • the lesion can be curetted and injected with phenol

Endoscopic pilonidal sinus treatment involves debridement of the pilonidal sinus under direct visualisation using a fistuloscope. Recurrence rates are low, wound complications are low, time to healing is moderate, and time to return to activities is quick (1).

Reference

  1. Gil LA, Deans KJ, Minneci PC. Management of pilonidal disease: a review. JAMA Surg. 2023 Aug 1;158(8):875-83.

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