I will not be going into the specifics of the different surgery types available for pilonidal sinus treatment – there are hundreds.
However, there are two main options for surgery – open-wound and closed-wound procedures.
Firstly, it is important to stress that surgery is the only way to treat the cause of the abscess and remove all of the infected tissue.
On the NHS pilonidal sinus page, there is an option to have the ‘incision and drainage’ to drain the pus out of the sinus. However, this will not remove the actual sinus.
As there are multiple, specific surgery options to choose from it is always best to see an expert in pilonidal sinus disease to evaluate your condition and make the decision on the surgery option you will need.
There are two main options when it comes to removing the pilonidal sinus – open wound and closed wound procedures – but there is a more specific surgery technique called the ‘cleft lift’, which I will discuss as one of the specific closed wound procedures.
Open Wound Procedure
This surgery type will involve a wide excision of the skin area surrounding the pilonidal sinus, with the sinus itself also removed.
The wound is left open to heal naturally from the inside and gradually closes together, should there be no complications.
You will require general anaesthetic for this procedure – the usual recovery time (depending on the specific surgery method used) is 6-12 weeks.
Closed Wound Procedure
This surgery type is when the sinus is removed and the skin is stitched together straight away.
You will either have dissolvable stitches that disappear naturally, or stitches that are removed anywhere from 7-14 days post-surgery.
I must reiterate that you should always speak to an expert in pilonidal sinus before having your surgery. I am someone who went through five different surgeries in 18 months, all because the wrong surgery was conducted at the start.
Cleft Lift Procedure
The ‘cleft lift‘ procedure is considered to be one of the most successful pilonidal sinus surgeries to date, with a success rate of over 95%.
Even the more complex recurrences of pilonidal sinus disease can be cured by the cleft lift procedure. Also, there is only mild post-operative pain (as opposed to the more common open or midline closures, which leave a large cavity or significant tension).
The traditional midline closure is one of the most common pilonidal sinus surgery techniques, yet does not have a high success rate for healing – it’s an outdated technique. The cleft lift, however, is more practical than other procedures and does have an extremely high success rate.
The cleft lift procedure to treat pilonidal sinus disease can only be performed by a handful of surgeons in the UK. Mr Carapeti is one of those, so if you would like to find out more information about this procedure, you can visit his Top Doctors page.
There are multiple approaches to treating pilonidal sinus with over 100 different surgery options (all falling under the open and closed wound approaches). This is why you must see an expert before going ahead to increase the chance of success.
PNS Hub is more focused on the aftercare post-surgery; however, I cannot stress enough the importance of having the correct procedure carried out for your surgery. Please make sure to see a specialist for this.