What is the treatment for pilonidal sinus?
Video Assisted Laser Ablation of the Sinus tract:
In this method of treatment, a special VAAFT scope is used to visualize the sinus tract and along with that all the debridement, infected material removal and all hair removal is done using the Video endoscope and after that, a laser beam is used to ablate the entire tract and lead to resolving of the sinus tract.
Wide excision and healing by secondary intention.
This operation involves cutting out (excision of) the sinus but also cutting out a wide margin of skin which surrounds the sinus. The wound is not closed but just left open to heal by natural healing processes (healing by 'secondary intention'). This usually requires several weeks of regular dressing changes until it heals fully. The advantage of this method is that all inflamed tissue is removed and the chance of the condition coming back (a recurrence) is low.
Excision and primary closure.
This means taking out the section of skin which contains the sinus. This is done by cutting out an oval-shaped (ellipse) flap of skin either side of the sinus, which takes out the sinus. The two sides of the ellipse are then stitched together. The advantage for this is that, if successful, the wound heals quite quickly. The risk of a recurrence or of developing a wound infection after the operation is higher than with the above procedure. This risk may be reduced by using a wound technique in which the line of stitches is moved away from between the buttocks.
A plastic surgery technique.
In some cases, where the sinus recurs or is extensive, plastic surgery may be advised to remove the sinus and refashion the nearby skin. Which is called a Flap Surgery.