Types of surgery

The type of surgery that you have depends on:

• the size of your pilonidal sinus
• your symptoms
• if you have previously had an infection of your pilonidal sinus

Your surgeon talks to you about the different types of surgery and which is best for you.

Your recovery after surgery is slightly different depending on what type of surgery you have. 

Surgery to remove the pilonidal sinus

You might have surgery to remove the pilonidal sinus. This can be done using stitches to close the wound. We can also leave the wound open to heal by itself, without using any stitches.

If you have stitches, they might dissolve by themselves or they might need to be removed after surgery. Your surgeon tells you which type of stitches you have.

If the stitches need to be removed, you make an appointment with the practice nurse at your GP surgery. They remove your stitches 2 weeks after surgery.

Limberg flap reconstruction

This type of surgery removes the whole pilonidal sinus and the affected tissue around it. We move healthy skin from your bottom to cover the area that has been removed.

You need to stay in hospital for about 2 nights after this type of surgery. Your wound has stitches that need to be removed at the hospital about 2 weeks after surgery.

EPSiT (endoscopic pilonidal sinus treatment)

Your surgeon can use a thin, flexible tube with a camera on the end (an endoscope) to look inside your pilonidal sinus.

The surgeon uses small instruments with the endoscope to treat and clean the area. They might also use heat to stop any bleeding and to help your pilonidal sinus heal.

The wounds made during this procedure are small and should heal quickly, with less discomfort. This allows you to return to your usual activities and work much sooner. 

Risks of surgery for a pilonidal sinus

Your surgeon talks to you about the risks of surgery before asking you to sign a consent form.

The risks of surgery include:

• infection in the area where you had surgery, which can be treated with antibiotics
• bleeding or a blood clot (called a haematoma). This does not usually cause serious problems, but you sometimes need more surgery to drain the blood

You have surgery under general anaesthetic. This means that you are asleep and do not feel any pain. A doctor called an anaesthetist meets you before surgery to tell you more about this and explain any risks.

Sometimes, your pilonidal sinus and symptoms can return after surgery. If this happens, you might need to have more surgery.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have surgery, we ask you to sign a consent form. This says that you agree to have the treatment and understand what it involves.

If you would like more information about our consent process, speak to a member of staff caring for you.