LASER PILONIDAL SINUS SURGERY

 

Pilonidal sinus disease is a benign disease which presents as swelling or discharging sinuses in lower back or sacrococcygeal region. Its incidence is up to 26 cases per 100 thousand of general population each year. It mostly occurs between the 15th and 25th year of active life. Males suffer from pilonidal sinus disease more often because of the hairy lower back and buttocks. It is also called Jeep's disease because during the Second World War lots of jeep driving soldiers got affected by it. The disease most commonly happens in those who have excess hair over the lower back and the supra anal cleft.

 

THIS DISEASE CAN PRESENT IN 2 FORMS

  1. Acute phase - The acute phase is characterized by the presence of abscess/swelling /redness/severe pain/ inability to sit in lower back.
  2. Chronic phase – The chronic phase is featured by discharging sinuses and swelling.

TREATMENT
In acute infected pilonidal cyst,surgery in the form of Incision and drainage and debridement can resolve this condition. Usually this cures the problem but if the cyst comes back, it will need to be treated again as chronic case.

In Chronic cases the treatment is surgical excision of all sinus tracts followed by either
1. Primary closure of the wound
2. Leaving the wound open and allowing the wound to heal by secondary intention
3. Limberg/Rhomboid Flap surgery to cover the defect.

 

 

Recurrance is a problem even after surgery in about 10% of cases as the cause is excessive hair in the area that breaks and gets embedded into the skin of the natal cleft.

IDEAL TREATMENT FOR PILONIDAL SINUS AIMS AT-

1. Reducing hospital stay
2. Avoiding excessive tissue assault by way of avoiding unduly extensive procedure
3. Early resumption of work
4. Avoiding recurrence

Hence, Laser Pilonidal cyst surgery is a new minimally invasive method to cure this disease with reasonably low recurrence rates.

Laser surgery is a relatively quick and effective treatment for pilonidal cysts. In this surgery the cyst pockets are cleaned of embedded hair, debris and infected material. The wound is flushed out with antiseptic fluid.Subsequently,a special thin laser fiber is used to close the sinus. The laser light destroys the lining of the tract and collapses the opening.

The patient is advised to regularly depilate/shave the area by either shaving creams/shaving blades. Once the wound heals, it is advisable to permanently reduce the hair by lasers to reduce hair growth and prevent recurrence.


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