Pilonidal Disease
Sacrococcygeal pilonidal sinus is a common disorder among young adults. Occurring after puberty when sex hormones are known to affect the pilosebaceous gland and change healthy body hair growth. The onset of pilonidal disease is rare in people older than 40 years. The condition results from infection around hairs embedded in the skin, commonly occurring in the cleft between the buttocks. Some people are born with small holes or pits near the base of the spine. These are in fact enlarged hair follicles, which when subjected to friction and motion, are injured and disrupted so the hair pokes through the wall of the follicle into the surrounding skin setting up a foreign body reaction. Neighbouring hairs or free hairs from other parts of the body collect in the pit and invade the small opening created by the distorted hair follicles. Skin and perineal bacteria such as Staphylococcus aureus and Bacteroides species invade the opening and cause infection.There are several common patterns of this disease. Nearly all patients have an episode of an acute abscess.After the abscess resolves, either by itself or with medical assistance, many patients develop a pilonidal sinus.
The sinus is a cavity below the skin surface that connects to the skin with one or more small openings or tracts. Most patients need a small operation to eliminate them since they frequently become infected. Pilonidal disease may involve three common occurrences first is Acute Abscess Formation is abscess formation between the buttocks second is Simple Sinus and last. Complex or recurrent disease a small number of patients with a resolved pilonidal sinus go on to develop complex or recurrent pilonidal disease. Patients suffering from recurrent pilonidal disease have persistent, non-healing wounds. Pilonidal disease is now widely accepted as an acquired disorder based on the observations that congenital tracts do not contain hair and are lined by cuboidal epithelium. The recurrence of the disorder after complete excision of the disease tissue down to the sacrococcygeal fascia and the high incidence of chronic pilonidal sinus disease in patients who are hirsute further support an acquired theory of pathogenesis.
Causes of Pilonidal Disease
Common causes of Pilonidal Disease
- Acute abscess.
- Family predisposition.
- Poor hygiene.
- Repeated local injury.
- Pilonidal cysts.
- Stretched.
- Ingrown hairs.
- Pilonidal sinus.
Symptoms of Pilonidal Disease
Common symptoms of Pilonidal Disease
- Redness or swelling.
- Cloudy fluid or blood draining.
- Pain.
- Swelling.
- Heat.Fever.
- Weakness.
- Nausea.
- swollen.
- tender.
- Drain pus.
- Chills, or malaise..
Treatment of Pilonidal Disease
Common Treatment of Pilonidal Disease
- Phenol injections used as treatment of the pilonidal sinus. Phenol injections may be combined with local excision of the sinus. Wound healing usually requires 4-8 weeks.
- Marsupialization is a compromise between primary wound closure and wound healing by secondary intention. Marsupialization provides the patient with a smaller wound compared to wounds that are left open to granulate. By suturing the wound open, wound infection is prevented and the subcutaneous tissue is covered, resulting in reduced healing time. Healing is usually complete by 6 weeks.
- Skin flaps have also been described to cover a sacral defect after wide excision. Similarly, this keeps the scar off the midline and flattens the natal cleft. The potential complications include loss of skin sensation in the flap, which is observed in more than 50% of patients, and necrosis of the flap edges.
- During and after healing, the buttocks crease must be kept clean and dry, and hair-free to prevent the infection.
- Physical Activity helps cleansing, it brings balance and relieves stress.physical activities will help you balance your body and will help you relief accumulated stress.
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