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Got operated for pilonidal sinus. Noticed lump near the wound. Will this result to another surgery for sinus?

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Oncologist, Surgical
Practicing since : 2008
Answered : 576 Questions
Hi Doctor
I am a patient for pilonidial sinus.. I got operated 2 months back and the wound was left open for normal healing. Fortunately, the doctor told me 2 days ago that he can see the granular tissue being developed and the dressing was also dry(dressing always used to get wet previously). I have been regular in my visit to doctors for dressing change. I go usually every alternative day.
But recently, I got it changed after 7 days. In the mean time, I noticed a pea sized lump [hard and painful] near the affected area. Just trying to understand if it is normal or more serious than I actually think? It is there because there is still infection inside which could result to another surgery for sinus? OR is it normal and will go by itself in next 2-3 days? Is it because I took more than normal for dressing change this time? Do I kill this pea sized lump by medicines? if yes, what medicines do you recommend? OR do I need another small surgery right away to get it drained, if it is because of any pus inside. I am worried as I have already had 2 surgery's for the same- first in 2009 and second surgery recently- 2 months back!
Posted Mon, 27 Aug 2012 in Peptic Ulcer
Answered by Dr. Rohan Khandelwal 9 hours later
I can understand your concern regarding your condition and I am glad that you are seeking medical advise for the same.

It usually takes 5-6 days for granulation tissue to appear and it is very strange that in your case it has taken almost 2 months. This is suggestive of some cause of delayed wound healing (either infection or a residual sinus).
This pea sized lump can either be infection or a recurrence. You need to visit your surgeon and have him evaluate it. In the meantime I would suggest that you continue with your medicines and Sitz bath (sitting in a tub of warm water).

Pilonidal sinus is a condition which is known to recur and that only cure is proper surgery. Please consult your surgeon and have him evaluate your condition but it usually does not take 2 months for the wound to heal.

Hope you get well soon.
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