Is surgery compulsory for pilonidal sinus disease ?
Incision and drainage: This is a simple procedure Incision and drainage: This is a simple procedure that involves making an elliptical incision in the abscess just off the midline. The mouth of the wound should be of sufficient width to allow packing of the entire wound cavity. Curettage to remove dead or infected tissue in the wound improves the rate of healing, with 90% completely healed at one month, compared to just 58% healed at 10 weeks in the absence of curettage. Following a single incision and drainage procedure, 40-60% will go on to develop a PNS requiring further surgery. Pits or sinuses can be excised as part of an incision and drainage procedure, but these can be obscured by oedema and are often overlooked at the initial assessment. The recurrence rate can be reduced to about 15% if a second procedure to excise pits and sinuses is performed after five to seven days. Healing by secondary intention has the advantage of allowing free drainage of infected material and debris.
