You’ll have been recommended to have pilonidal sinus surgery (also known as excision of pilonidal sinus) due to an infected tract, commonly containing hair, under the skin between your buttocks.

There are two different surgical methods used: wide excision of pilonidal sinus or excision and primary closure of pilonidal sinus. Your Consultant will advise the best pilonidal sinus surgery for you.

Wide excision of a pilonidal sinus

Wide excision involves cutting out the section of skin containing the sinus, leaving the wound open and packed with a dressing. The chances of an infection returning are low however, your wound will take a long time to heal and you’ll need daily dressing changes for two to three months.

A wide excision is carried out under general anaesthetic, so you’ll be asleep during the operation.

Excision and primary closure of a pilonidal sinus

This procedure involves cutting out the affected skin and then stitching the wound closed. While your wound will heal more quickly, there's a greater chance of the infection returning. This treatment is also carried out under general anaesthetic.

You may have some discomfort after your operation which we’ll help relieve with painkillers. You may have a small plastic drain in place, which is normally removed after 24 hours. You should be able to go home after two days.

If the wound has been left open, it will have a dressing that needs changing each day and this may be uncomfortable. More often the wound will be stitched and covered with a light pad; this is not usually painful. If you have a stitch it will need to be removed at around 10-12 days after your operation.

Whatever type of pilonidal sinus surgery you have, it is important to keep the site of the wound clean. Depending on your treatment, you may need to keep the area completely dry. You’ll probably be more comfortable wearing loose-fitting cotton underwear and, to reduce any straining when you go to the toilet, a high-fibre diet may be suggested to help soften your stools. Our experienced clinical team will discuss these arrangements with you before you go home.

You’ll probably need time off work, depending on how you feel and the type of work you do. You should avoid any strenuous work or exercise which might reopen the wound.

There’s a risk of infection at the site of the wound or that the pilonidal sinus returns. You should contact your GP immediately if you have any signs of infection such as pain, red or swollen skin, a high temperature, a feeling of heat at the site of the wound, fluid, pus or blood leaking from the site of the wound or an unpleasant smell coming from the site of the wound.

For details of cost, view the colorectal surgery section of our pricing page or contact our Private Patient Team on 01580 363158.