Pilonidal Sinus Surgery

What Is Pilonidal Sinus Surgery?

Pilonidal sinus surgery is a procedure to treat a small tunnel or tract under the skin, typically located near the tailbone at the top of the buttocks crease. A pilonidal sinus often contains hair, skin debris, and can become infected, forming an abscess or recurring painful cyst. Our experienced surgical team offers tailored treatment to eliminate the sinus, relieve symptoms, and prevent recurrence—using both traditional and minimally invasive techniques where appropriate.

What is a Pilonidal Sinus?

A pilonidal sinus is a small opening in the skin that leads to a tract beneath the surface, which can become infected and filled with pus. It’s most commonly caused by ingrown hairs and friction in the area.

Symptoms may include:

Pain or tenderness near the tailbone
Swelling or redness
Pus or blood discharge
Recurrent infections or abscesses
Fever (if infection is severe)

When is Surgery Needed?

Surgical treatment is recommended for:

Recurrent or chronic pilonidal sinus infections
Abscesses that don’t fully heal with drainage alone
Persistent pain or drainage
Sinuses that don’t respond to conservative management

Types of Pilonidal Sinus Surgery

Incision and Drainage: For acute abscesses
Excision with Open Healing: The sinus is removed and the wound is left open to heal naturally
Excision with Primary Closure: The wound is closed with sutures after removing the sinus
Minimally Invasive Surgery (Pit Picking, Endoscopic Excision “EPSiT” Procedure): Smaller incisions and faster recovery for select cases
Flap Surgery (for complex or recurrent cases): Used to flatten the natal cleft and reduce recurrence risk

Your surgeon will discuss the best approach based on your condition.

Benefits of Pilonidal Sinus Surgery

Relief from recurring pain, infection, and discharge
Reduced risk of abscess formation
Long-term resolution of pilonidal sinus disease
Improved hygiene and comfort

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Before Surgery: Preparation

Medical Assessment

Physical exam, blood tests (including thyroid function), ultrasound, and fine needle aspiration (FNA) of any nodules
Scans such as CT, MRI, or thyroid scintigraphy may be ordered
An anaesthetic assessment to ensure surgical readiness

Medication Management

Inform your surgeon about all medications and supplements
You may need to stop certain medications such as blood thinners several days before surgery
If you are on thyroid medications, dosing instructions will be provided

Fasting

Do not eat or drink anything for at least 6–8 hours before surgery

Practical Preparation

Arrange transport home and support for the first 24–48 hours
Wear comfortable, loose-fitting clothing
Remove any jewelry, especially around the neck

After Surgery: Recovery & Aftercare

In-Hospital Recovery

Most pilonidal surgeries are performed as day procedures under local or general anaesthesia
You’ll be observed briefly post-surgery and discharged the same day

At-Home Recovery

Wound Care

If open healing, daily wound care and dressing changes are essential
Keep the area clean and dry
Follow instructions for sitz baths, topical creams, or wound cleaning
If the wound is sutured, avoid pressure on the area and follow up for stitch removal

Pain Management

Mild to moderate pain is expected; take prescribed pain relievers as directed

Hygiene

Gently wash the area as advised and avoid harsh rubbing
Avoid prolonged sitting and tight clothing

Activity

Rest for the first few days
Resume light activity as tolerated
Avoid strenuous activity, biking, or sitting for long periods for at least 2–3 weeks

Hair Removal

Long-term hair removal (shaving, depilatory creams, or laser) may be recommended to reduce recurrence

Follow-Up

Regular follow-up visits to monitor wound healing
Contact your surgeon if you notice:
- Increased redness, swelling, or drainage
- Fever or chills
- Severe pain
- Reopening of the wound

Ready to Take the Next Step?

Book Your Consultation

If you’re experiencing symptoms of a pilonidal sinus or have had repeated infections, our team is here to help. We provide expert assessment, personalised surgical planning, and thorough post-operative care.

Contact us today to book your consultation and take the first step toward relief and recovery.