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- Page navigation anchor for First do no harm: Managing pilonidal sinus diseaseFirst do no harm: Managing pilonidal sinus disease
‘Tips for GP trainees working in colorectal surgery’ offers one sentence on pilonidal sinus disease (PSD). It is “unusual in the over 40s”.1 GPs need so much more knowledge about this relative common, and often poorly managed, disease. There is almost an acceptance that PSD is ‘difficult to treat’, recurrence rates inevitably high, and patients should not be surprised if their wounds to take months to heal. Recurrence rates are high, but this is often iatrogenic harm following surgery. Mahmood explains that “early recurrence is due to failure to identify one or more sinuses at operation, whereas late recurrence is usually due to secondary infection, residual hair or debris not removed at operation, inadequate wound care or insufficient attention to depilation”.2
Training for surgeons seems to be woefully inadequate. Less than half carrying out pilonidal operations considered themselves sufficiently trained, and more than 70% felt that PSD was an underprioritized, low status area of medicine.3
Training for GPs is inadequate too and if you have never talked to your patients about pit picking4 or cleft lift surgery, you are not alone. What practical advice do you give patients about wound management, cleansing and hair removal?
It is true that PSD tends to affect young people, with a deleterious impact on their physical, social, working, and emotional lives....
Show MoreCompeting Interests: None declared.