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Pilonidal sinus disease

Localized purulent infection of skin and subcutaneous tissue are in gluteal furrow, formed on the place of ingrown and inflamed hair (remains of the embryonic development). It is induced by prolonged sitting (professional drivers – ‘jeep seat disease’), greasy, hairy skin (more often in men), excessive swearing (athletes – cyclists, rowers).

Symptoms: pain, localized swelling and redness, difficulty sitting, even walking; elevated temperature. Symptoms degrade with spontaneous spraying and expulsion of pus-like content; inflammation quickly relapses, usually with stronger intensity.

Treatment is exclusively surgical.
In the acute phase it is possible to do an incision and simply evacuate the pus;
In remission, it is necessary to definitively solve the problem: do an excision (cutting) of the growth completely, together with the abscess capsule and complete content; cavity needs to be washed, do drainage and leave it wide open due to spontaneous gradual healing.
There is significantly less tissue trauma if the procedure is done with in radiofrequency technique.

Preparation

Act according to instructions previously given by an anesthesiologist: the day before the procedure, after light supper, it is, perhaps, necessary to take a mild laxative in order to ensure morning defecation. In the morning, it is advised to drink 3-5dl of Donat Mg and after that, stop taking liquid and eating. Common therapy, if necessary, take according to standard scheme or according to the arrangement made by anesthesiologist during the preoperative exam.

Recovery

Shortly after the procedure, the patient is, with an escort, discharged home with a recommendation for analgesic therapy during the next 2 days.
After a couple of days, the patient is already capable of work and other activities.

Patient hygienic-dietary regime:
  • avoid prolonged sitting in the beginning
  • avoid ‘fast food’, pay attention to fiber intake, with a lot of residue
  • intake of minimum 2-2,5 l of fluid daily
  • do not postpone defecation
  • wash with warm water after defecation
  • permanent laser hair removal of the gluteal region is recommended

Side effects and complications

As well as with other surgical procedures in this region, bleeding of different volume is possible. But, with correct preparation of the patient and adequately performed technique by an expert surgeon, this complication is negligible.

Package

Package includes: preoperative examination by an anesthesiologist, procedure itself, thromboprophylaxis if necessary, analgesics for 1-2 postoperative days and control examinations during the next 6 months.
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