Nursing and wound management
i
Nursing management of a pilonidal sinus includes:
o
Management of pain is important, particularly in patients admitted as an emergency
3
o
Nurses should give consideration to any underlying conditions that may be a contributing factor or give rise to complications, such as
diabetes, use of steroids, weak immune system, etc
2
o
It is also very important that clinicians remember that patients may be unprepared for the size of the wound that may be uncovered, as
the opening of the abscess itself may appear small
o
The patient’s vital signs, such as temperature, are also important as an indicator of potential infection
2
i
Specific wound care considerations when dealing with a pilonidal sinus include:
o
Wounds in this area can heal quickly as they are well perfused, however healing can be affected by organisms regularly found in the natal cleft
6
o
Due to the frequency of dressing changes required — and the pain involved
6
— dressings that not only conform to the wound, but which
are non-traumatic on removal (i.e. gelling fibre dressings), should be considered in this area
o
Due to the delicacy of the periwound skin and the location of these wounds, a dressing that can absorb exudate, preventing leakage, and
conform well to the wound bed is desirable
6
o
Shaving around the periwound skin can also help with atraumatic removal of dressings, as well as preventing recurrence.
6
The publishers and Mölnlycke Health Care cannot accept responsibility for the use of this information in clinical practice, which does not diminish the requirement to exercise
clinical judgement and follow local policy.
sponsored by
1.
Grant T (2009)
Wounds UK
5(1)
: 78–80
2. Stephen-Haynes J (2008)
Wound Essentials
3:
128–33
3. Timmons J (2007)
Nurs Stand
21(52): 48–56
4.
Lanigan MD, Dyne PL
(2015)
Medscape
Available at: emedicine.medscape.com
5.
Nursing Standard
(2003)
Nurs Stand
99(14):
28
6. Bradley L (2006)
Wounds UK
2(1): 45–53
Exufiber
®
is a gelling fibre dressing
with Hydrolock
®
Technology for
use on exuding wounds such as
pilonidal sinuses. For samples
and information, visit:
www.molnlycke.co.uk/exufiber
To download this poster, go to:
www.jcn.co.uk
Treatment
i
There are several treatment strategies for pilonidal sinus, including
2
:
o
Conservative: particularly used in non-severe presentations and involves antibiotics to clear any infection and prevent surgery, as well as
preventative measures such as regular cleansing and shaving of the area
o
Minor surgery: in smaller non-infected cases any hair can be removed from the abscess/follicle and the track cleaned out
o
Surgery: including excision of the affected tissue — including abscesses and inflammation — followed by primary closure; and wide
excision, where the sinus is ‘laid open’ and heals by secondary intention.
Credit:
