Pilonidal Sinus In Ano-genital Region Of 15yo Male

giovanni0359 · #11 ● 11-21-2013, 06:54 PM

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.

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The fistula network after incision and staining with methylen blue

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The wound after excision

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

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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.

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

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

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

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

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

Damn, a girl I knew had anal warts and she just had to tell me about em.