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 dition is more than merely a par tic u lar form of foreign body granuloma. The ideal method of treatment for pilonidal si nus should be the one hav ing min i mal post op er a tive mor bid ity, ex cel lent cosmetic re sults, min i mal tis sue loss, rapid re sumption of daily ac tiv i ties, low cost, and a low re currence rate. How ever, al though nu mer ous op er a tive and non-op er a tive treat ment meth ods have been described, 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 cision with marsupialization, and re cently, flaps surgery. The man age ment of pilonidal si nus dis ease will depend 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 ical 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 sinus dis ease in the of fice out pa tient set ting while as suring a near-nor mal work sta tus and should be preferred over excisional op er a tions at the out set.