Ingrown hair or pilonidal (nest of hair) sinus (cavity or channel) is a narrow, infected channel that extends from the skin surface, through the subcutaneous tissue, muscles, sometimes to the tailbone (coccyx). It mainly occurs between the ages of 20 and 40, more often in men.
There are two theories about the causes of the pilonidal sinus. According to the first, older theory, the cause of such a problem is ingrown hair. According to the other theory, the condition results from congenital pilonidal dimple, caused by the penetration of skin into deeper tissues. This ingrowth leads to duplication of epithelium in the place where it is not naturally expected - under the skin, which leads to the formation of a solid channel which needs to be surgically removed.
At the very beginning pilonidal sinus is an asymptomatic, painless lump. However, pain and discharge occur later. The disease occurs as an acute pilonidal cyst, chronic pilonidal abscess or complex pilonidal disease. The only successful manner of treating chronic pilonidal sinus is surgical removal. Throughout history several methods have been generated in general surgery aiming to solve this problem (open method, gradual healing, using fibrin glue or phenol). These methods have never resulted in a favorable outcome and full recovery, and they have also included long-term postoperative wound healing, wound leakage and re-emergence of the sinus.
Reconstructive surgery provides a permanent solution for this problem
The procedure is performed under general or local anesthesia, depending on the progress of the process.
After applying methylene blue diagnostic marker and surgical removal of pilonidal sinus, the reconstruction of skin and subcutaneous tissue defect is performed using local fasciocutaneous flap. The wound is sutured in two layers, using fine sutures so that the consequent scar is later barely noticeable. The patient leaves the hospital the very same day. During the next 15 days the patient should sit down carefully and regularly maintain the hygiene of anogenital area. Sitting and driving a car is not recommended for three weeks after the procedure. Sutures are removed 15 days after the procedure, when the patient may resume his/her everyday activities. After such an intervention the problem does not recur.
Pilonidal sinus – cystic phase – 1600 – 1900
Pilonidal sinus – previously operated – 2900
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Plastic surgery practice 
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