LAUSR

Pilonidal sinus wounds are notoriously slow to heal and have a high risk of infection due to proximity to the anus, the moist environment of the natal cleft and friction of buttock cheeks. Since the first pilonidal sinus disease (PSD) protocol was issued to the US army in 1955, care for PSD has focused on the principles of wound care following surgical excision with secondary or modified closure, including cleaning of the wound, hair removal and daily dressings. These principles remain valid today, although advances in the choice of dressings and laser therapies for long-term hair management allow patients more independence and less frequent dressings. At present, there are no standard guidelines for wound care following pilonidal sinus (PS) surgery. This article recommends thorough wound cleaning, starting laser depilation early and individualised patient education to accelerate wound healing and reduce recurrence. Collaboration between specialists in a multidisciplinary team is essential.