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Pilonidal Disease


remove pilonidal Sinus in operation room ( surgery treatment )           image of Pilonidal diseases surgery treatment                       

 ? What is pilonidal disease and what causes it
Pilonidal disease is a chronicinfection of the skin in the region of the buttock crease.The condition resultsfrom a reaction to hairs embeded in the skin,commonly occurring in the cleftbetween the  buttocks.The  disease is more common in men than women andfrequently occurs between puberry and age40.It is also common in obeses peopleand those with thick, stiff body hair.

?What are the symptoms

Symptoms vary from a small dimple tolarge painful mass. Often the area  will drain fluid that may be clear,cloudy or bloody .With infection ,the area becomes red , tender, and thedrainage(pus)will have a foul odor. The infection may also cause fever,malaise, or nausea.

There are several common patterns ofthis disease.Nearly all patients have an episode of an acute abscess.(the areais swollen,tender,and may drain pus).After the abscess resolves,either byitself or with medical assistance,many patients devlop a pilonidal sinus. Thesinus is a cavity below the skin surface that connects to the surface with oneor more small opnings or tracts. Although a few of these sinus tracts mayresolve without therapy ,most patienrs need a small operation to eliminatethem.

A small number of patients developrecurrent infections and inflammation of these sinus tracts. The chronicdisease causes episodes of swelling,pain and drainage . Surgery is almostalways required to resolve this condition.








  ?How ispilonidal disease treated


The treatment depends on the diseasepattern. An acute abscess is managed with an incision and drained to releasethe pus, and reduce the inflammation and pin .This procedure usually  anbe performed in the office with local anesthesia.

A chronic sinus usually will need tobe excised or surgically opened.

Complex or recurrent disease must betreated surgically . Procedures vary from unroofing the sinuses to excision(Figure 2) and possible closure with flaps.

Larger  operations requirelonger healing times.If the wound is left open ,it will require dressing or packingto keep it clean . Although it may take several weeks to heal , the successrate with open wounds is higher.Closure with flaps is a bigger operation thathas a higher chance of infection ;however, it may be required in some patients. Your surgeon will discuss these options with you and help you select theappropriate operation.


 ? What care isrequired after surgery

If the wound can be closed ,it willneed to be kept clean and dry until the skin is completely healed.If the woundmust be left open ,dressings or packing will be needed to help removesecretions and to allow the wound to heal from the bottom up.

After healing, the skin in thebuttocks crease must  be kept clean and free of hair.This is accomplishedby shaving or using a hair removal agent every two or three weeks until age 30.After age 30 ,The hair  shaft thins,becomes softer and the buttock cleftbecomes less deep.




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