Pilonidal Sinus

Last updated 24/04/18

Definition

• Chronic acquired inflammatory disease of buttock cleft hair follicles

Features

• Incidence 26:100,000
• Higher incidence in young people
• Males 2.5:1 females

Causes

Associated Signs & Symptoms

Risk Factors

• Deep natal cleft

Complications

Differential Diagnosis

Investigations

Management

• Surgery
• Anaesthetic choice
• General Anaesthetsia (GA)
• Prone or lateral
• Intubation
• Spinal anaesthesia
• Local Anaesthesia (LA)
• Technique
• 6ml 2% Lidocaine with Adrenaline (1:200,000)
• + 6ml 0.5% Bupivicaine
• + Fentanyl 50mcg (1ml)
• + Clonidine 75mcg (1ml)
• +/- Midazolam 1.5-3mg IV for sedation
• Less postoperative pain
• More rapid recovery

---

References

Rahmani N. et al. Pilonidal Sinus Operations Performed Under Local Anaesthesia versus the General Anesthesia: Clinical Trial Study. Global Journal of Health Science. 2016;8(09):200-206