Pilonidal Sinus Excision with Primary Closure
Surgical excision of pilonidal sinus tracts with direct closure — for limited single-tract disease.
What is Pilonidal Sinus Excision with Primary Closure?
Pilonidal sinus excision with primary closure involves complete surgical removal of the sinus pits, tracts, and granulation tissue, followed by direct suture closure of the wound. It is suitable for simple, limited single-tract pilonidal disease without extensive branching in patients with a shallow natal cleft. Dr. Tagore Mohan Grandhi performs pilonidal sinus excision. Post-operative laser hair removal of the natal cleft is strongly recommended to prevent hair re-implantation and reduce the 10–15% midline recurrence rate associated with direct closure.
How the Procedure Works
Sinus Tract Mapping
Methylene blue dye or probe mapping identifies all pits and tracts for complete excision.
Elliptical Excision
Elliptical excision made around all sinus pits and tracts. Dissection extends to presacral fascia.
Primary Closure
Wound edges closed in layers with absorbable deep sutures and non-absorbable skin sutures.
Wound Care
Wound reviewed at day 5 and day 10. Sutures removed at 10–14 days.
Hair Removal
Post-operative laser hair removal of the natal cleft at 6 weeks to prevent hair re-implantation and recurrence.
Outcomes
Who Needs This Treatment?
- →Simpler and quicker than flap surgery for limited single-tract disease
- →Same-day surgery with early return to activity
- →Post-operative laser hair removal significantly reduces the 10–15% recurrence
- →If recurrence occurs, off-midline flap surgery remains available
Primary closure is the simplest approach for limited pilonidal disease. Combined with post-operative laser hair removal of the natal cleft, recurrence rates approach those of flap surgery in carefully selected patients.
— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad
Common Questions
Frequently Asked Questions
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