There are many ways to deal with Pilonidal from leaving it open, to primary close, to destroy it with VAAFT, to making flaps to cover it. The case should be dealt appropriately according to the lesion. Dr D.U.Pathak

1. Pilonidal sinus repair primary
closure
Dr D.U.Pathak, Shalby hospital, Jabalpur (M.P) India

2. Excision
Position is left lateral.
Anaesthesia local block
Xylocaine adrenaline is injected all
around.
Methylene blue instilled in sinus to
demarcate the cavity.
Sinus excised and edges
undermined

3. Excised wound
Sinus is extracted
having included
whole cavity stained
by methylene blue.
The edges are
undermined for
tension free closure.
Hemostasis is achieved.

4. Drainage
Suction drain placed

5. Wound closure
Wound closed in two layers.
It should be a tension free closure.

6. Results
Wound heals well if whole infected sinus is excised thoroughly
Proper haemostasis done
And
Stitches removal is delayed.