The Pilonidalsinus (Pilus=Hair,
Nidus=Nest) is an inflammatory illness situated under the coccyx skin. Altering
forces of pressure and tension have an effect on the hair root (follicula)
located at the cenral edge of the coccyx bone. This leads to inflammation and
skin holes (pits). The inflammation can extend and form tracts as well as bags
under the skin. Sometimes abscesses could develop. Hair do not exist
necessarily. Secondary collection is possible if hairs pushed forward under the
skin by movements of the buttocks.
- Vast hairs
- Shape of the folliculas
- Construction and shape of the coccyx skin
- Skin effecting activities (Seated occupations, drivers, riders)
- Excessive sweating
- Lack of hygiene
The illness can run absolutely unnoticed and free of pain. Inflammation of
tissue can lead to swelling, redness and abscess, which is very painful. In rare
cases malignant change of tissue could be possible.
The healing of the pilonidal sinus is only possible by removing of the infected
hair folliculas. There are different operation methods which were developed as
open, closed or flap techniques. In case of an abscess only the pus is emptied.
If necessary a second operation can be carried out later.
As an alternative to the operation phenol and silver nitrate treatment is
performed, which was introduced already decades ago. We do not applicate this
method because of low results and high toxicity.
In our clinic an abscess is drained and cleaned via a lateral cut. The small
remaining wound stays open and heals by itself. The discomfort after the
intervention is minimum and the everyday life is not impaired.
At the operation of a pilonidal sinus, the skin will be opened in an elliptic
shape. The pilonidal sinus is then cleaned completely by the diod laser and skin
is closed laterally after shifting (modified Karydakis flap or Cleft lift). This
elegant method shows high success and low recurrence rates. Employability is
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