Management of complicated sacrococcygeal pilonidal sinus disease

This case study documents the treatment interventions and outcomes of a young man with complex pilonidal sinus (PNS) disease. The healing process fluctuated, with periods of improvement and regression. Various wound care products were introduced with the aim of optimising wound bed preparation and healing. Seven general anaesthetics were required to perform surgical interventions, examine wound progress or to apply topical negative pressure wound therapy. The delayed wound healing caused disappointment and frustration for the patient, his family and the team involved in his care. The challenges were exacerbated as treatment took place during his final year of school, while completing the Higher School Certificate (HSC). No preexisting medical conditions contributed to the delayed healing. Primary wound closure or flap techniques were not recommended due to infection and proximity to the anus. Complete healing was achieved in 343 days.