Endoscopic Pilonidal Sinus Treatment (EPSIT)
What is pilonidal sinus?
Pilonidal sinus (pns) is a small hole or tunnel in the skin. It may fill with fluid or pus, causing the formation of a cyst or abscess. It occurs in the cleft at the top of the buttocks. A pilonidal cyst usually contains hair, dirt, and debris
A pns is a condition that mostly affects men and is also common in young adults. It’s also more common in people who sit a lot, such as taxi drivers .
Common signs and symptoms?
You may not have any noticeable symptoms at first other than a small, dimple-like depression on the surface of your skin. However, once the depression become infected, it will quickly develop into a cyst (a closed sac filled with fluid) or abscess (a swollen and inflamed tissue where pus collects).
The signs of an infection include:
- Pain when sitting or standing
- Swelling of the cyst
- Reddened, sore skin around the area
- Pus or blood draining from the abscess, causing a foul odor
- Hair protruding from the lesion
- Formation of more than one sinus tract, or holes in the skin
You may also experience a low-grade fever, but this is much less common.
Causes of pilonidal sinus:
Pilonidal cysts are caused by groups of hairs and debris trapped in the pores of the skin in the upper cleft of the buttock, forming an abscess. Risk factors include being male, sedentary, having thick body hair, family history, being overweight, and previous pilonidal cysts.
Pilonidal Sinus treatment
Treatment for an infected pilonidal sinus will depend on your symptoms, the size of the sinus and whether its your first sinus or it keeps coming back. Pilonidal abscess will need antibiotic treatment and the pus inside will also need to be drained .
There are a number of treatment options for pilonidal sinus that keeps coming back and that are painful, bleeding or leaking discharge. Your doctor will discuss these options
1. Incision & Drainage – A small hole is made in the abscess so the pus can be drained
2. Excision and open healing – the sinus is cut out and some surrounding skin removed. The wound is left open to heal naturally
3. Excision and wound closure – The sinus is removed, and an oval-shaped flap of skin cut out on either side of it. The 2 sides are stitched together.
4. Endoscopic treatment for a pilonidal sinus (EPSIT) – Is the latest minimally invasive surgical technique for pilonidal disease. EPSIT is a new video assisted technique for the treatment of the pilonidal sinus disease and its recurrences, an endoscope (a thin, flexible tube with a camera on the end) is used to give a clear view of the affected area.
Hair and infected tissue are removed, and the sinus cleaned with a special solution. Heat is used to seal the sinus.
How soon you can return to work depends on the procedure you had, most of the people are able to return to work within 2 weeks of the surgery , you need to keep the affected are clean , wear comfortable loose fitting cotton underwear , eat plenty of fiber to make going to the toilet easier and avoid straining , you may need antibiotic and pain killers.