Treatment may not be necessary if your pilonidal sinus does not become infected. The area can be kept clean and dry, and the surrounding hair removed by shaving or with hair removal creams. However, infected pilonidal sinuses are treated with surgery. Your doctor may perform any of the following procedures:
Incision and drainage: This procedure involves cutting open the sinus tract and draining the pus from the abscess. This is a minor procedure and is usually performed under general anesthesia. You will be able to return home either on the same day of the procedure or the day after. A dressing will be applied, and you will have to visit your doctor’s office daily for dressing changes.
For recurrent infections of your pilonidal sinus, you may be recommended to undergo surgery to remove the sinus and prevent further infections with any of the following procedures:
Excision and Reconstruction with local advancement flap: During this procedure, your surgeon will surgically remove a section of your skin along with the infected sinus. This will reduce your chances of a reinfection. Your wound will be then closed with the mobilization of a skin flap from the skin around the area where the excision to place. This is a fairly specialized form of surgery which allows nice and effective reconstruction after tissue excision in a body area where healing after these type of surgery is usually very difficult to achieve.
This procedure is fully day case and the patient does not require overnight. Despite the reconstruction involves the creation of the flap, postoperative pain is very limited and the recovery after surgery happens usually within a week.