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Pilonidal sinus

Welcome

At Mater Health Services we understand that being in hospital can be a very stressful experience. This booklet aims to alleviate some of your concerns in keeping with our Mission to offer compassionate, quality care that promotes dignity while responding to patients’ needs. It explains briefly the events that may occur during your visit and the things to expect when you are discharged from the hospital.

It is, however, only a guideline as each person may require differing treatments.

If you have any questions about your treatment please ask your doctor or nurse.

Our pastoral care team offers a caring support network to all patients. The dedicated members of this team will visit you during your stay and are available at your request to discuss any anxieties or problems that you may have.

Pilonidal sinus

A Pilonidal sinus is a tract which commonly contains hair and skin debris and is prone to recurring infections. It is almost always located near the tail bone at the top of the cleft of the buttocks.

This condition usually occurs in young adults (and more often with males) between the ages of 15 and 24.

A sinus may cause no noticeable symptoms at the beginning when it is first developing.

The only sign of its presence may be a small pit in the surface of the skin. The symptoms may then develop quickly or gradually over time.

If symptoms develop quickly, pain and swelling will increase over a number of days as an infected abscess develops in and around the sinus. This is very painful and tender. If symptoms develop, gradually the sinus may discharge some pus which releases the pressure and reduces the pain. However, the infection never clears completely so the pain and discharge can persist for the long-term or flare up from time to time until the sinus is treated.

In most cases an operation is advised. The most common operation is the cutting out of the sinus as well as a wide margin of skin surrounding the sinus. The wound is not stitched but left to heal by normal healing processes. This wound will take weeks to heal and requires regular dressings until it heals. The advantage is that all the inflamed tissue is removed and the chance of reoccurrence is low.

Another treatment is cutting away the section of skin that contains the sinus and stitching the sides closed. The wound heals quite quickly but there is higher risk of recurrence of infection with this method of treatment.

What are the risks of having pilonidal sinus surgery?

Although this type of surgery is almost always safe, complications are a risk factor, just as they are with any kind of surgery.

Here are some potential complications relating to this surgery:

  • anaesthesia complications—nausea and reaction to the anaesthetic
  • pain—you will be given tablets to help control the pain
  • bleeding of the wound
  • scarring
  • blood clots—rarely these can form in the legs due to immobility after surgery. Occasionally a blood clot can break off and travel through the blood stream to the lungs, making it difficult for you to breathe
  • partial breakdown of the wound—this is more common if the wound is closed with stitches. The risk increases if there is an infection at the time of surgery. The wound may need to be opened and packed until it heals
  • slow healing—healing can take up to eight weeks or longer, especially if the wound is packed
  • feeling numb—it is common to have numbness around the wound.

After your operation

You will stay in the recovery room within the theatre suite after the operation while you wake up from the anaesthetic. You will be transferred on your bed to your post operative room.

Medication

You will have a drip (IV) in place. This is necessary to maintain your fluid intake. This will be removed when you are tolerating adequate amounts of oral fluids.

You may experience mild to moderate pain after surgery. Please tell your nurse as there are medications which can be given to relieve this pain. It is important to be comfortable.

Observations

Your nurse will take frequent observations of your vital signs (e.g. temperature, pulse, blood pressure etc) and wound for several hours after your surgery. As you become fully recovered, these become less frequent but remain regular until you leave hospital.

Hygiene

About four hours after you return to the ward, your nurse will assist you to have a wash. In the days following your surgery you will be encouraged to be independent with your hygiene.

Whether you shower, sponge or have sitz baths is dependent on the type of surgery you have had and your doctor's orders.

Activity

Immediately following your surgery, you will be resting in bed.

footThe following exercises help prevent complications such as chest infections and blood clots in your legs. You should do these every hour that you are awake while resting in bed.

Breathing exercises: take five long and slow deep breaths.  Each breath should be deeper than the previous breath.  Think about getting the air to the very bottom of your lungs.

General anaesthesia (medication for sleep during surgery) may affect you for 24 hours after surgery. Whether you feel drowsy, or fully awake, you may lack your usual coordination. When you feel well enough, you will be assisted the first time you get out of bed. It is important to stay off your operated area—therefore lying on your side or stomach is the position of choice (not on your back). If you are sitting, it is important not to be in the sitting position for more than 30 minutes. Putting pressure on your wound can delay the healing process.

Diet

To avoid nausea and vomiting following surgery it is important to slowly introduce foods. You will progress from clear fluids to a light diet depending on what you can tolerate. You should be eating your usual diet by the time you leave the hospital.

Wound

It is necessary for your wound to heal by the natural healing process from the wound bed up. With this healing process your wound will require regular dressings until it heals. Your doctor will give you instructions on how to manage this process.

The day you go home

It is usually expected that you will be going home the day after your surgery. Sometimes it may be necessary for you to stay an extra day, depending on your condition.

  • You will be ready to go home when:
  • your observations are stable
  • your pain is controlled
  • you are eating and drinking normally
  • there are no signs of complications or infections
  • you have received explanations regarding your wound care and follow-up appointments.

What to expect:

  • Once you are at home you should rest for the first few days, walking as little as possible to help the wound to heal.
  • Your wound dressing will require changing daily.
  • You should be able to return to work after a few weeks, but you will need to make arrangements with your nurse to continue your daily dressings.
  • Do not drive until you are comfortable and confident about controlling your vehicle.
  • It is important to keep the healing/healed area as clean as possible to reduce the risk of the sinus returning. Your doctor may advise you to remove hair from the area on a regular basis by shaving or other means to reduce this risk.

Contacts

Please contact either your general practitioner (GP) or Mater Hospital Brisbane Emergency Department on telephone 07 3163 8111 if you experience any of the following after discharge:

  • a fever above 38.4 degrees Celsius
  • excessive bleeding
  • an offensive smelling discharge
  • severe pain despite the use of pain killers.

Mater Hospital Brisbane

Raymond Terrace, South Brisbane Q 4101
Telephone: 07 3163 8111

South Brisbane campus

Acknowledgments

Staff of Mater Hospital Brisbane, Raymond Terrace, South Brisbane, Q 4101

© 2010 Mater Misericordiae Ltd. ACN 096 708 922.

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-420031
Last modified 09/8/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 11/8/2015
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