How do I get treatment

For London Colorectal please telephone:

  • +44 (0) 20 7403 6061

For Gastroenterology please call:

  • +44 (0) 20 7234 2292


Patient Advice following Pilonidal Sinus Surgery

A pilonidal sinus is an inflamed sinus tract or channel that commonly contains hair follicles. It occurs under the skin between the buttocks, a short distance above the anus. Germs can build up among the hairs within the sinuses causing pain, swelling and discharge.

There are various operations which aim to help in curing this problem. These include a wide excision of the sinus and surrounding skin, leaving the wound open for it to heal from within, or excision and primary closure, whereby the wound is sutured together. There is also the option of a Karydakis, Limberg or Rhomboid flap following the excision. Your surgeon will advise on the most appropriate method for you.

Following your surgery, your consultant will explain the extent of the problem with you as it is not usually possible to know this prior to surgery. They will also explain the method which has been used to treat your pilonidal sinus ie. wide excision and left open to heal by normal healing process or excision and primary closure.

  • It is advisable to continue to take pain relief as prescribed by your consultant especially prior to dressing changes.
  • Your wound may be left open and packed with a dressing known as Aquacel or Kaltostat each day. You can apply a dry dressing if the position of the wound will allow, otherwise it may be advisable to apply some sterile gauze over the area and keep in place with your underwear.
  • If your wound has had a primary closure, you will be advised of this and when and if the sutures need removing. You will be given advice regarding this prior to your discharge.
  • It will be arranged by the hospital prior to your discharge for your dressing to be renewed the following day, this can be either at London Bridge Hospital Outpatients Department or by your practice/district nurse at your GP practice.
  • It is important not to allow yourself to get constipated. You may require laxatives in order to prevent this. Your Consultant will discuss this with you prior to your discharge.
  • It is important to keep the area clean. Avoid washing with perfumed lotions and potions as these can irritate the area. If you have a detachable shower use this to clean the area well, especially prior to any dressing change.
  • You may experience some bleeding from the wound post surgery, this is normal and nothing to worry about. However if the bleeding should become excessive please inform your consultant and seek immediate attention.
  • It is advisable to avoid sitting or walking for long periods at first as this can cause friction.
  • You should avoid swimming until the wound has totally healed as the chlorine can irritate the wound and also you are at risk from picking up an infection.
  • You should not drive or operate machinery for at least 24-48 yours until you have fully recovered from the anaesthetic.
  • Depending on your job, you may be advised to take 1-2 weeks off in order to allow you to recover and also to enable you have the dressings regularly changed.