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Pilonidal disease is the formation of a hair-filled sac under the skin as a result of the prolongation (chronicization) of the inflammation of the subcutaneous hair follicles. Although it can be seen in every part of the body where hair follicles are dense, it is most common in the coccyx region. This area is a very difficult area to maintain due to its proximity to the anus area as well as because it is constantly in underwear. It is thought that the hairs shed in the hollow area here while in motion contribute to the formation of this disease.
Since hair density is higher in men, it is more often seen in young men, but the disease can also develop in women.
The most common complaint in patients is discharge from the coccyx region, which can be foul-smelling from time to time. If detected at this stage, it should be treated. If left untreated, this vesicle may become inflamed and become an abscess at any time in life, and in such a case, the abscess must be drained and healed without waiting. Since the healing process of the abscess will delay the actual surgery, it is the most appropriate solution to treat the pilonidal disease before such a problem develops.
Treatment of pilonidal disease is surgical or non-surgical interventional methods.
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In the surgery to be performed for pilonidal disease, the subcutaneous sac is removed without damaging its integrity and the remaining space is closed without tension. The remaining wound lips can be brought directly against each other (primary repair), or if it will be tight, this gap can be closed with tissue shifting (reconstruction with flap). It is also possible to leave this gap open to heal on its own (secondary healing), but in this method, the recovery is long and may take several months. If the remaining gap is closed, the recovery time is shorter, but inflammation may develop in this wound and the wound may be reopened, and precautions are taken for this. When the wound is left open, there is no risk of re-inflammation.
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The sac formed under the skin is opened out through very small holes. By entering through these holes, the inner walls of the vesicle are burned and adhered to each other with the help of laser, and it is aimed to eliminate the vesicle (laser ablation). In this method, the flow will continue for a while, and then the walls of the vesicle will stick together and the vesicle will disappear with the drying of the tissues.
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Similar to the laser ablation method described above, the walls of the vesicle can be destroyed with a special drug by entering through the holes in the skin. The process in this method is the same as in laser ablation.
In all methods, the probability of recurrence of the disease exists to some extent. While laser and drug methods are successful in relatively small diseases, it would be more rational to prefer the surgical method in large diseases.
After the surgery decision is made, the preparations are completed after a few simple tests and anesthesia examination and an appointment is made for the surgery. The patient comes to the hospital on the morning of the day of surgery, has the surgery, can go home after staying in the hospital for one night. If the closed opening is large, a drain can be placed to drain the fluids that will accumulate inside during the surgery. This drain is usually removed the day after the surgery, but it can be kept for a day or two from time to time, it does not prevent going home.
It is recommended that patients undergoing surgery do not sit by bending at the waist for a week, except for compulsory situations (eating, toilet, etc.) in order to support the adhesion of tissues. It will be appropriate for them to lie down or sit by slouching, except when standing.
The process of laser ablation is similar to surgery, the procedure is performed in the operating room. The patient can go home the same day, there is no sitting restriction.
Ablation with medication is performed under outpatient conditions, no preparation is required beforehand.
Patients coming from outside the city can return to their home cities after leaving the hospital. A week later they are called for a control examination. They can spend this time in their own city. If this is not possible, they should stay for one week in the city where the surgery or procedure is performed. _cc781905cfcdecde-cf581905cdecdecde-3194-bb3b-136bad5cf58d__cc781905cdecdecde-3194 -3194-bb3b-136bad5cf58d_ _cc781905_bbcde58-3194