Pilonidal Sinus/Abscess
Hair follicles get stuck under the skin in the natal cleft resulting in irritation and inflammation leading to small tracts which can become infected (abscess)
Epidemiology
Much more common in MALES than females
Commonly presents between 20-30 yrs
Risk Factors
Sedentary job
Occupation involving sitting or driving
Large amount of body hair
Family history
Obese caucasians and those from Asia, Middle East and Mediterranean are at increased risk
Pathophysiology
The ingrowing of hair excites a foreign body reaction and may cause secondary tracks to open laterally with or without abscesses, with foul-smelling discharge
Clinical Presentation
Acute
Chronic
Pus filled with mould smell from abscess
Systemic signs of infection
Painful swelling over days
4 in 10 have repeated recurrent pilonidal sinus
Infection never clears completely
Diagnosis
Treatment
Detected on clinical examination
Surgery
Hygiene and hair removal advice (near sinus)
Excision of the sinus tract and primary closure and pus drainage
Pre-op antibiotics