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Pilonidal Sinus and Abscess

What are pilonidal sinus and abscess?

Pilonidal sinus and abscess are conditions that involve the development of an abnormal tract or cavity in the skin near the tailbone (coccyx). While these conditions are more commonly seen in adults, they can also occur in paediatric patients.

What causes pilonidal sinus and abscess?

The exact cause of pilonidal sinus and abscess is not fully understood. 

However, they are believed to result from a combination of factors, including:

  • Hair Follicle Irritation: Hair follicles in the area may become inflamed or irritated, leading to the formation of a sinus or abscess.

  • Ingrown Hairs: Hairs that grow back into the skin instead of outward can contribute to the development of pilonidal sinus and abscess.

  • Friction and Pressure: Constant friction or pressure in the area, such as from sitting for prolonged periods or repetitive trauma, may play a role.

What are the symptoms of pilonidal sinus and abscess?

The symptoms of pilonidal sinus and abscess can vary but commonly include:

  • Pain, swelling, or tenderness in the lower back or near the tailbone.

  • Redness or inflammation in the affected area.

  • Drainage of pus or fluid from an opening (sinus) in the skin.

  • Formation of a painful lump or abscess.

  • Development of a sinus tract, which is a narrow channel that extends from the skin to deeper tissues.

How to treat pilonidal sinus and abscess?

The treatment approach for pilonidal sinus and abscess in paediatric surgery can involve a combination of conservative measures and surgical intervention. 

Here are the general treatment options:

  • Conservative Management: For small, uncomplicated pilonidal sinus or abscess, conservative management may be attempted initially. This can include warm compresses, proper hygiene, and the use of antibacterial or antiseptic creams to promote healing.

  • Incision and Drainage: If the abscess is large or causing significant symptoms, surgical incision and drainage may be necessary. This involves making a small cut to allow drainage of the abscess and relieve pressure.

  • Sinus Excision: In cases of recurrent or chronic pilonidal disease, surgical excision of the sinus tract may be performed. This involves removing the entire sinus tract and any associated debris or infected tissue.

  • Closure Techniques: After excision, the wound may be left open to heal by secondary intention (gradual healing from the bottom up) or closed primarily with stitches or other closure techniques, depending on the size and location of the wound.

  • Follow-up Care: Regular follow-up visits are important to monitor healing, ensure proper wound care, and evaluate for any signs of recurrence.

It's essential for the management of pilonidal sinus and abscess in paediatric surgery to be performed by a surgeon experienced in the treatment of these conditions. They will assess the specific circumstances of the child's condition and provide appropriate treatment recommendations based on their expertise and the individual situation.

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