Pilonidal sinus Abcess wont close...what to do now, pls read on :/

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My son is 16 and was finally sent to AE in Feb 2014 due to large painful abcess, when 3 lots of antibiotics didnt help. The next day they operated, General surgeon was not impressed that it was an 'emergency' and said so, but still did op. He scooped out abcess wound was left open. We were told it would close within 2-6 weeks. 5 months later he STILL has a hole and we can see his original sinus tract.  In April I  asked for MRI scan and was told no it would close eventually. I was then told it would need to be done again and referred to Colon/rectal dr. He until this week has said it will close, now he saying needs doing again and he has left the hospital, so it will be yet another surgeon.  What do i do?

Are there specialist in the UK that can deal with this? Surely the sinus (that almost goes to his spine) will not close on its own as its a tunnel!

 

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3 Replies

  • Posted

    Hi Furby,

    My son has been through the same thing. Firtsly the sinus will not heal if the the cause is from 'hair' becoming trapped in the wound! I had to painstakingly remove any invasive hair from around my sons wound and rinsing it will 'sterile' saline so that the wound could eventually heal, this took 6 months.

    It is important that the wound heals from the bottom upwards as you do not want it to heal from the sides too quickly leaving a sinus (hole) underneath!

    I do have a previous nursing background and am a qualified electrolygist, so I dont want to give you 'medical' advice but it is worth asking whether you son has a 'cavity' of unknown origin or if they think it's to do do with hair. if the latter you may need to dicuss this with your son and see if he will let you help him (this is obviously a very sensitive area for a young man and not one usually shared with his Mum! A colo-rectal surgeon has the specialist skills to help, so seek their advice first. 

    if you dont get any joy -medically, get back to me. All the best to you and your son.

    • Posted

      Hi rubikscube, he's had the sinus since birth an open lil hole in cleft, unfortunately the area was infected so he developed an abcess, theytook out abcess and 'sinus' supposedly but the sinus hole still there just deeper into the cleft. He has sterile wash, packing and dressings daily. Been advised to shave area, but upon looking into it, this can cause ingrowing hairs compounding the issue; it has healed to a point and now wont heal anymore due to the sinus, i guess!

      So the colon rectal surgeon said got to have further investigations, but im not sure if this IS the right thing to do, General Surgeon clearly didnt do it correctly in first place not sure if i want them to make another mistake ..nothing is ever straight forward with my son, bless him smile

  • Posted

    Hi Furby,

    So sorry your son continues to suffer.  Trimming (not shaving) the hair will stop it from curling into the wound. Be careful not to let any loose hair drop into the wound though as this will act as a foreign body and continue the infection. This process should not cause ingrowing hairs. If there are hairs close to the edge of the wound these can be plucked out (but obviously this will take a magnifying glass and patients-both you and him-or anothe trusted person). 

    If the wound is not infected and clean, perhaps you could request to see a specialist 'wound management nurse' or plastic surgeon although getting the advice of the colo-rectal surgeon wouldn't hurt. 

    PS if you help to remove any hair-use 'sterile' tweezers. Stainless steel-in Milton. Do not leave them in too long or use ordinary metal as they will rust. 

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