Pilonidal Sinus Treatment in Delhi, India

A pilonidal sinus is a small tunnel or tract that forms in the skin near the tailbone (sacrococcygeal region), just above the cleft of the buttocks. A pilonidal sinus is a small tunnel or tract that forms in the skin near the tailbone (sacrococcygeal region), just above the cleft of the buttocks. This condition occurs when hair and debris penetrate the skin, leading to inflammation and infection. Sometimes, these openings may be filled with pus or other fluid, forming an abscess or cyst. These occur at the crevice on the upper portion of the hips. Pilonidal cysts often contain dirt, hair, or debris. When infected, it may lead to severe excruciating pain.

Once it is infected, pus or blood can be seen oozing out from the site. PNS is a disorder that primarily affects men but is also prevalent among young people. It's also more frequent among people who spend a lot of time sitting, such as cab drivers. At BLK Max Hospital, Delhi, specialized surgeons offer comprehensive diagnosis and treatment using advanced minimally invasive and surgical approaches for complete recovery and reduced recurrence.

Alternate Name of Pilonidal Sinus

Pilonidal abscess, Pilonidal disease, Pilonidal cyst

Causes of Pilonidal Sinus

Although the exact reason for the disease is unknown, certain factors are found related to the occurrence of this condition. These factors include:

• Ingrown Hair: Hair penetrating the skin and causing chronic irritation or infection.
• Prolonged Sitting: Common in drivers, office workers, and students, leading to pressure and friction in the sacrococcygeal area.
• Poor Hygiene: Accumulation of sweat, dead skin cells, and bacteria in the gluteal cleft.
• Local Trauma: Repeated friction or minor injuries around the tailbone region.
• Hormonal Factors: Common during puberty and early adulthood when oil gland activity and hair growth increase.
• Obesity: Excess body weight adds pressure and increases skin friction.
• Family History: A hereditary predisposition may also play a role.

When you sit or perform other activities that cause friction, the hair developing in the region can burrow back under the skin. In response to this hair, the body mounts an immune response similar to what it would do to a splinter. When this response occurs, your body produces the cyst surrounding the hair. Many people can have more than one sinus under the skin.

Symptoms of Pilonidal Sinus

The natal cleft, which is the apex of the buttocks crease, right beneath the tailbone, is affected by a pilonidal sinus. Depending on the severity of the illness, symptoms might range from moderate to severe.

The common signs and symptoms observed are as follows:

• Pain and tenderness
• Tiny depression in the skin
• Discharge of pus or blood from a small opening on the skin
• Foul odour from the discharge
• Growth of a painful mass or abscess. The fluid may also contain blood or maybe clear.
• Swelling and redness in the buttock cleft area
• A visible pit or dimple at the top of the buttocks
• Formation of multiple sinus tracts in chronic or recurrent cases
• Fever, Nausea, and general discomfort during active infection

In chronic cases, the infection may subside temporarily but recur periodically, emphasizing the need for medical evaluation and definitive treatment.

Pilonidal Sinus Diagnosis in Delhi

Sacral osteomyelitis can be misinterpreted as a pilonidal sinus because the sacrum is close to the rectum. Both these conditions have some symptoms in common, such as pain, reddening, and swelling. Other conditions which might be confused with a pilonidal sinus are:

• Abscess
• Hidradenitis suppurativa
• Inflammatory bowel diseases
• Anal fistula

Diagnostic Process:

1. Physical Examination:
   The surgeon visually inspects the sacrococcygeal area to identify sinus openings, inflammation, and discharge.
2. Sinogram (Fistulogram):
   A contrast study that helps outline the sinus tract, its depth, and branching pattern for surgical planning.
3. Ultrasound or MRI Scan:
   Used in complex or recurrent cases to determine the full extent of infection and tissue involvement.
4. Microbiological Culture:
   If pus is present, it may be sent for culture to identify the causative bacteria and guide antibiotic therapy.

Pilonidal Sinus Treatment;

The pilonidal sinus treatment plan is based on the type and stage of pilonidal sinus. These are as follows

1. Conservative Management (for Early or Mild Cases):

In cases with minimal infection and no active abscess:

• Antibiotic therapy to control infection
• Warm compresses and local hygiene maintenance
• Hair removal and preventive skin care

However, these measures are temporary and do not address the underlying sinus tract.

2. Minimally Invasive Procedures

Endoscopic Pilonidal Sinus Treatment (EPSiT):

A highly advanced and minimally invasive technique performed using a small endoscope inserted through the sinus opening.

• The surgeon visualizes the tract on a monitor, removes embedded hairs and infected tissue, and irrigates the area.
• The wound is left to heal naturally with minimal scarring.
  Benefits:
• Day-care procedure
• Minimal pain and blood loss
• Rapid recovery and low recurrence rate

Laser Pilonidoplasty:

In this technique, a laser fiber is introduced into the sinus tract to ablate the infected tissue and seal the cavity from within.
Advantages include:

• No large incisions or stitches
• Reduced postoperative pain
• Quick healing and low recurrence

3. Surgical Treatment (for Chronic or Recurrent Cases)

Excision and Primary Closure:

The sinus tract and surrounding tissue are surgically removed, and the wound is closed with sutures. Suitable for small, uncomplicated cases.

Flap Procedures (Limberg, Karydakis, or Rhomboid Flap):

For complex or recurrent cases, a flap of healthy skin and tissue is rotated to cover the excised area, reducing tension and recurrence risk.
These techniques ensure faster wound healing and better cosmetic outcomes.

At BLK Max Hospital, all surgical treatments are performed by experienced general and minimal access surgeons using evidence-based techniques and advanced equipment to ensure optimal recovery and minimal complications.

Minimally Invasive and Surgical Treatment Methods – A Comparative Overview

Pilonidal Sinus Preventions

The following steps can be taken to avoid a pilonidal sinus.

• Maintain good local hygiene and dryness of the gluteal cleft
• Remove excessive hair regularly (through laser or trimming)
• Avoid prolonged sitting or pressure on the affected area
• Maintain healthy body weight and exercise regularly
• Wear loose, breathable clothing

Post-Treatment Care for Pilonidal Sinus

Postoperative care plays a vital role in preventing recurrence and ensuring smooth recovery.

• Keep the surgical site clean and dry
• Follow prescribed dressing and follow-up schedules
• Take antibiotics and analgesics as directed
• Avoid strenuous activity until the wound heals completely

The surgical and nursing teams at BLK Max Hospital provide detailed postoperative guidance to ensure recovery and prevent recurrence.

Possible Complications of Pilonidal Sinus

A pilonidal sinus can lead to a variety of problems when left untreated or when the condition recurs even after the surgery has been done. These complications include:

• Intense pain
• Swelling and inflammation in the skin
• Low-grade fever
• Pus drainage from the site of infection or surgery
• The foul stench from the wound
• Poor wound healing
• Numbness in the wound
• Bleeding
• Scarring
• Allergic reaction and blood clotting
• In the worst-case scenario, it may lead to osteomyelitis, and skin cancer or bone cancer.

Why Choose BLK Max Hospital for Pilonidal Sinus Treatment in Delhi?

BLK Max Hospital is a premier tertiary care center offering advanced treatment for Pilonidal Sinus with a focus on clinical precision, safety, and long-term results.

• Expert Surgical Team: Highly qualified general and minimal access surgeons specializing in colorectal and anorectal conditions.
• State-of-the-Art Infrastructure: Equipped with advanced diagnostic tools, endoscopic and laser surgical systems.
• Comprehensive Care: From diagnosis to recovery, each stage is managed under strict medical supervision.
• Minimally Invasive Techniques: EPSiT and laser treatments for minimal pain, faster healing, and lower recurrence.
• Personalized Treatment Plans: Based on sinus complexity, recurrence risk, and patient health.
• Postoperative Care & Rehabilitation: Dedicated nursing and follow-up teams for continuous support.

BLK Max Hospital’s multidisciplinary approach ensures patients receive world-class surgical care with proven outcomes and enhanced quality of life.

Epidemiology of Pilonidal Sinus

26 per 100,000 people. Pilonidal illness is more common in men, with a 3-4:1 male-to-female ratio. It affects mostly Caucasian individuals in their late teens to early twenties, with a decrease after age 25 and a rarity after age 45.

Expected Prognosis of Pilonidal Sinus

Overall, the prognosis for pilonidal sinus is very good and it hardly causes long-term injury. After treatment, a pilonidal sinus might reappear, but keeping excellent cleanliness practices and eliminating hair from the region will help lessen the chances.

Pathophysiology of Pilonidal Sinus

The most commonly recognized notion about pilonidal sinus illness is that it begins with an infected or inflamed hair follicle in the crevice area above your buttocks. This inflammation blocks the follicle's entrance, causing it to stretch inwards, leaving a pit or a hole. This may later develop like a tube to form a sinus-like structure.