[Sharon]

A pilonidal sinus occurs when hairs in the natal cleft penetrate the skin. These subcutaneous displaced hairs cause irritation and inflammation. The area subsequently becomes infected, which may lead to abscess formation. On examination, the area feels as though multiple ‘grape pips’ are present under the skin. A lack of stringent personal hygiene and microtrauma can increase the likelihood of abscess formation and fistulae.

Case report

A 15-year-old boy presented with an ongoing fistulating pilonidal sinus in his ano-genital region, which had been present for approximately 18 months. The area was producing a continuous, offensive exudate that had caused him to withdraw from all sports and was affecting his school and social life. The area had previously been treated by performing a daily wash-out of the wound during showering and the application of a diluted iodine solution (Betadine) and dry gauze dressings.


The fistula network after incision and staining with methylen blue


The wound after excision


The wound with the V.A.C.® foam dressing in place


A sudden leakage of exudate from the wound occurred on the third dressing change
The slough and debris were removed and a new V.A.C.® foam dressing applied.


More exudate, slough and debris was detected on the wound surface on the fourth dressing change


The wound after complete removal of the exudate, slough and debris on the fourth dressing change


After 12 days the wound was clean and granulation tissue was present


The closed wound after 12 days of V.A.C.® Therapy


The wound after removal of the stitches. After closure, the wound healed without further problems

[PTSD Is My Life]

Nasty nasty nasty!!!

The V.A.C. wound healing system is a great leap forward for these kinds of wounds to the team who invented it :)

[Spitfire Dynamo]

My husband had that exact same issue. They did "reroofing" surgery; it a took very long time to heal but it finally cleared up.

[robbierob]

shit I feel sorry for the lad, I hope he is much better now, i can not begin to imagine the pain he endured :(

[Shakey]

Never had a problem with the asshole area ( at least behind me ) and I hope I never do.

[JynnJamin]

I went through that my freshman year of high school. The most painful thing I've ever experienced. Even compared to childbirth (both vaginally and c-section). It's a shame the internet and youtube weren't around back then; I'd have some wicked pus video's to share.

[Leahdc]

I had that surgery about 5 years ago. I didn't have the vac packing but rather they sewed it up right away. I ripped out all the stitches about a week later in my sleep. I woke up with a bed full of blood and my dr said it then had to heal from the inside out. It healed fine and I haven't had a problem since but the pain from the infected cysts was terrible. Plus when they would release all the pus, oh the smell was awful :(

[Spiffyfable]

Wow... that looks like a shitty ordeal

[LadyCPlum]

Damn, hemorrhoids seem like a walk in the park compared to this shit!

[mshope24]

Ano-genital.... Hmmm.. Would that be considered the same thing as a gooch or taint?