PILONIDAL SINUS

• Pilonidal sinus means nest of hair.
• It is an acquired condition found in the natal cleft of the coccyx consisting of one or more usually non- infected midline openings which communicate with a fibrous track lined by granulation tissue & contains loose hair within the lumen.
• It is also called as Jeep- disease.
• More common in hairy males.
• Age 20- 30 years.

 Etiology-

• Interdigital pilonidal sinus common in hairdressers.

Clinical Features-

• Intermittent pain, swelling & discharge at the base of the spine.
• Repeated abscess
• Sinus opening seen between sacrococcygeal joint & tip of coccyx.
• Sites of pilonidal sinus is midline over the coccyx, umbilicus & interdigital in barbers.
• Recurrence.

Investigations-

• X- ray of the coccyx.

Treatment-

• Inject methylene blue for branches of sinus followed by excision of sinus. (Jack knife position).
• 2 methods for treatment-

1. Open wound- packed with iodine or eusol gauze
2. Closed wound is closed by Z plasty.

• Rhomboidal flap
• Karydakis procedure
• Bascom’s technique