Non surgical management of pilonidal sinus disease

Abstract

When cosiidering how to treat pilonidal si nus, phy si cians should keep in mind that this con di tion is more than merely a par tic u lar form of for eign body granuloma. The ideal method of treat ment for pilonidal si nus should be the one hav ing min i mal post op er a tive mor bid ity, ex cel lent cos metic re sults, min i mal tis sue loss, rapid re sump tion of daily ac tiv i ties, low cost, and a low re cur rence rate. How ever, al though nu mer ous op er a tive and non-op er a tive treat ment meth ods have been de scribed, no ap proach com prises all of these fea tures. Nu mer ous treat ment op tions have been pro posed for the pilonidal dis ease, in clud ing shav ing, re moval with open pack ing, in ci sion and drain age, ex ci sion with pri mary clo sure,phe nol ap pli ca tion, cryosurgery,ex ci sion with marsupialization, and re cently, flaps sur -gery.The man age ment of pilonidal si nus dis ease will de pend on pa tient as sess ment, ex am i na tion and his tory of the con di tion. A dis ease-spe cific his tory and phys i cal ex am i na tion should be per formed, em pha siz ing symp toms, risk fac tors, and the pres ence of sec ond ary in fec tion. Con ser va tive ther apy can fairly con trol pilonidal si nus dis ease in the of fice out pa tient set ting while as sur ing a near-nor mal work sta tus and should be pre ferred over excisional op er a tions at the out set.