Closed Excision for Pilonidal Sinus
Excision of the pilonidal sinus with primary closure — the wound is sutured shut immediately, dramatically reducing healing time compared to open excision.
About This Treatment
Closed excision (excision with primary closure) removes the pilonidal sinus and immediately closes the wound with sutures. This avoids the weeks of open wound packing required after open excision, allowing patients to return to work much faster.
The closure is typically done off-midline (the Karydakis or Bascom procedure) — placing the suture line slightly to one side of the natal cleft rather than directly in it. Off-midline closure is critical for success because the midline crease is the zone of maximum pressure and moisture where wounds break down most easily.
Closed excision is ideal for primary (first-time) pilonidal sinuses of moderate complexity. It offers an excellent balance between healing time and cure rate.
Key Benefits
Faster Return to Work
2–3 weeks vs 6–12 weeks for open excision. Dramatically reduced healing time.
No Daily Wound Packing
Wound is closed with sutures — no daily painful dressing changes required.
Good Cure Rate
85%+ cure rate for primary pilonidal sinuses — excellent balance of effectiveness and recovery.
Why Choose This Treatment?
| Feature | This Treatment | Traditional |
|---|---|---|
| Healing Time | check2–3 Weeks (Closed) | 6–12 Weeks (Open) |
| Daily Dressing | checkNot Required | Required (daily packing) |
| Cure Rate | check85% | 90%+ (Open) |
| Best For | checkPrimary / Moderate Complexity | Complex / Recurrent |
Before Treatment
- 01
Confirm absence of active infection (a clean sinus — no abscess or acute discharge).
- 02
Pre-op blood tests, anesthesia fitness evaluation, and shaving of the area.
- 03
Fasting from midnight before surgery.
After Treatment
- 01
Keep the suture line clean and dry. Shower normally from Day 2, pat dry the wound.
- 02
Sutures are removed at 10–14 days.
- 03
Avoid prolonged sitting on hard surfaces for 3 weeks.
- 04
Laser hair removal strongly recommended after healing to prevent recurrence.
- 05
Follow-up at suture removal and 6 weeks post-op.
Frequently Asked Questions
Fast Recovery with Closed Pilonidal Surgery
Get back to work in weeks, not months. Closed excision offers an excellent cure with a much faster recovery than open surgery.