ANORECTAL / SKIN CONDITION · CONDITION GUIDE

Pilonidal Sinus

Q: Is pilonidal sinus surgery painful?

Surgery is performed under spinal or general anaesthesia and is not painful during the procedure. Post-operative discomfort in the natal cleft area lasts 1–2 weeks and is managed with oral analgesia. Limberg flap closure generally causes less post-operative pain and allows faster return to sitting than open excision.

Q: How likely is pilonidal sinus to recur after surgery?

Recurrence depends on the technique used. Open excision with healing by secondary intention has a recurrence rate of 10–15%. Primary midline closure has higher recurrence. The Limberg flap carries the lowest recurrence rate — under 5% — by eliminating the natal cleft that predisposes to the condition.

Q: How can I prevent pilonidal sinus from coming back?

Regular hair removal from the natal cleft — by shaving, laser, or depilatory cream — significantly reduces recurrence by preventing hair penetration. Maintaining a healthy weight, reducing prolonged sitting, and keeping the natal cleft clean and dry are also important preventive measures.

A chronic skin condition in the natal cleft containing a sinus tract lined with hair and debris — causing pain, discharge, and recurrent abscess formation requiring surgical excision.

Book on WhatsApp Call Clinic

Laser Pilonidal Sinus Treatment – Minimal Access Sinus Surgery by Dr. Tagore

Young Adults MOST AFFECTED

30–60 Min PROCEDURE DURATION

Day Case – 1 Day HOSPITAL STAY

ABOUT THIS CONDITION

What is Pilonidal Sinus?

A pilonidal sinus is a small hole or tunnel in the skin at the top of the natal cleft (the groove between the buttocks), containing hair, debris, and granulation tissue. It causes recurrent abscess formation, chronic discharge, and pain, particularly when sitting. It predominantly affects young adults, particularly males with dense body hair, and is aggravated by prolonged sitting, obesity, and poor natal cleft hygiene. Dr. Tagore Mohan Grandhi treats pilonidal sinus at Lux Hospitals, Hyderabad, offering incision and drainage for acute abscess, and excision procedures for chronic sinus disease. The Limberg flap reconstruction is used for wide or recurrent sinuses, filling the defect with local flap tissue to prevent the deep natal cleft that predisposes to recurrence.

SIGNS TO WATCH

Common Symptoms

⚠️

Symptoms that need attention

Chronic pain, tenderness, and swelling in the natal cleft Intermittent or constant purulent discharge from the sinus opening Acute abscess formation causing severe pain, swelling, and redness Multiple sinus openings in longstanding disease Discomfort when sitting for prolonged periods Skin excoriation and soiling from persistent discharge

WHY IT HAPPENS

Causes & Risk Factors

Hair penetrating the natal cleft skin creating a foreign body reaction
Deep natal cleft creating a moist environment favouring hair penetration and infection
Prolonged sitting — a significant occupational risk factor
Obesity and sedentary lifestyle predisposing to natal cleft hygiene issues
Dense, coarse body hair increasing penetration risk
Previous pilonidal abscess leaving granulation tissue and sinus tracts

CLINICAL DETAILS

KeyFacts

Common Group

Young adult men with dense body hair

Acute Treatment

Incision and drainage of pilonidal abscess

Definitive Treatment

Excision with primary closure or Limberg flap

Recurrence

Limberg flap has the lowest recurrence rate

Recovery

2–4 weeks for open excision; faster for flap closure

Hospital

Available at Lux Hospitals, Hitech City, Hyderabad

HOW WE TREAT IT

Treatment Approach

✦

Limberg Flap Reconstruction

The Limberg rhomboid flap reconstruction excises the pilonidal sinus and fills the natal cleft defect with local transposed tissue, eliminating the deep cleft that predisposes to recurrence. Dr. Grandhi recommends the Limberg flap for wide, recurrent, or complex pilonidal disease, offering the lowest published recurrence rates and primary wound healing.

Available at Lux Hospitals, Hitech City, Hyderabad

1

Assessment & Acute Management

Clinical examination identifies the extent of sinus disease and any concurrent abscess. Acute abscesses are drained urgently under local anaesthesia. Definitive surgery is planned after resolution of acute infection.
2

Procedure Selection

Simple sinuses with few pits are treated by excision with primary closure. Wide or recurrent disease is treated with Limberg flap reconstruction to obliterate the natal cleft and reduce recurrence.
3

Surgical Excision or Flap Reconstruction

Under spinal or general anaesthesia, the sinus and all tracks are excised with a margin of normal tissue. The defect is closed primarily or reconstructed with a Limberg rhomboid fasciocutaneous flap.
4

Wound Care & Prevention

Wound care and hair removal (laser or shaving) of the natal cleft are maintained post-operatively to prevent recurrence. Weight management and reduced sitting time are recommended.

AVAILABLE TREATMENTS

TreatmentOptions

Incision and Drainage of Pilonidal Abscess

Urgent drainage of acute pilonidal abscess under local or regional anaesthesia. Provides immediate relief; definitive excision is performed subsequently.

Pilonidal Sinus Excision with Primary Closure

Wide excision of the pilonidal sinus and all tracks with primary wound closure off the midline. Suitable for limited sinus disease with few pits.

Limberg Flap Reconstruction

Excision of the sinus and natal cleft with rhomboid flap transposition to fill the defect, obliterate the cleft, and achieve the lowest recurrence rate.

Laser Pilonidal Sinus Treatment

Laser energy is used to ablate the sinus tract with minimal cuts and faster healing.

View All Treatments ↓

COMMON QUESTIONS

Frequently Asked Questions

Is pilonidal sinus surgery painful?+

How likely is pilonidal sinus to recur after surgery?+

How can I prevent pilonidal sinus from coming back?+

Not sure about your condition?

Compassionate, confidential consultations — Book your appointment today.

WhatsApp Us ← ← All Conditions