nursemom

New Member
My son had surgery in July. It was a lateral incision. The surgeon went in to the left of the midline, tunneled over and cut out the sinus and surrounding tissues. The sinus extended under the midline, so though she did not make an actual open incision of the midline, she did have to cross it to get at all the tissue. The incision was left open to heal and drain with packing, which in the beginning was quite harrowing. The incision has almost fully healed and my son is basically back to normal. However, about 2 weeks after the stitches were removed, a small hole opened on the midline. The doctor inspected it, found no hair or sinus and used a silver nitrate stick to cauterize. I packed it with a 1/4 wound packing tape to drain and heal from the inside and in a little over 2 weeks it was completely closed. Now we are waiting for full healing so we can go get the laser hair removal, but on labor day, I noticed another even smaller hole open. It was about 1/4 in below the first that opened and about 1/2 the size. It was maybe a 1-2 mm in diameter. I could see the tissue behind the opening- it was nice and red and didn't appear to have any hair or otherwise in it. The only drainage from the hole was a tiny amount of blood. I covered it with the packing tape and the silk bandage tape and within 48 hours it had closed.

So my question is- does anyone else have experience with this? I called the doctors office and for various reasons it's a bit of a hassle to get in soon. Also, my son is sick of dealing with this entire thing so I'm really trying not to panic and cause him a lot of extra stress. They are concerned that it could be a pit that was missed, although it does not seem to be 100% guarantee that that is the case. I thought it could also be that the tissue and skin there is weak since she had to cross the midline to clean out the sinus tissue. Is that just wishful thinking on my part? I've kept it covered with the silk tape during the day and activity, which seems like it would help reinforce the skin and help keep it more stationary while it heals.

I'm wanting to go ahead with the laser hair removal as soon as possible, as long as there is no open hole on the midline. I'm just wondering if anyone else has experience or stories they could share that might give me an idea if I'm for sure looking at a missed pit. If it is a missed pit, is there any chance that using a silver nitrate stick could resolve it?

Also- any experience with a pit picking in this situation? Is it really as simple as people have made it sound?
Any tips on how I can tell if it is just a hole or a pit?

thanks for any support-
 

sanichka

New Member
You say it was left open to heal and then you say the stitched were removed. Confused about that. Maybe request an MRI or Ultrasound? But the doctors usually can tell by looking and he said it wasn't a sinus...Sometimes the scar just splits. Good luck!
 

nursemom

New Member
Right, so on the stitches and open healing it is both. The incision is a lateral incision off the midline- so not open excision. That was left open to heal from the inside. The stitches were on the midline, over the area where the sinus was removed. But the midline wasn't opened, the sinus was removed by tunneling over from the lateral incision and leaving the skin closed along the midline. I feel pretty certain based on what I've seen there is no sinus remaining. But what exactly is a "pit" I'm still not 100% clear on that.

Thanks for any help in understanding the nuance of this stuff
 

sanichka

New Member
Okay now I understand. Good question. I sometimes confuse a pit with a sinus as well. But I found a thread where the difference between a pit and a sinus is explained. Here is the link. Hopefully it will help.
surg

"a pit i believe is a dimple where your more succeptible to developing a new cyst but not neccisarily where one already exists and a sinus is a hole or tunnel that leads to the cyst."


https://www.pilonidal.org/xfforums/...he-difference-between-a-pit-and-a-sinus.6430/

So I guess a pit would be visible when you look at the skin? Its all so confusing isn't it. I had open healing surgery myself in January I healed really well and it was closed for 5 months before splitting open. I am told now there is a deep "hole" and my surgeon calls in a pilonidal fistula. I am living in Germany at the moment so they have their own terminology.

I totally understand you and your son's frustration. It will be over one day. Hopefully this hole is just a split and it will close. Splits are common!
 

Epilepsymom

New Member
Right, so on the stitches and open healing it is both. The incision is a lateral incision off the midline- so not open excision. That was left open to heal from the inside. The stitches were on the midline, over the area where the sinus was removed. But the midline wasn't opened, the sinus was removed by tunneling over from the lateral incision and leaving the skin closed along the midline. I feel pretty certain based on what I've seen there is no sinus remaining. But what exactly is a "pit" I'm still not 100% clear on that.

Thanks for any help in understanding the nuance of this stuff
Hello. Who do you recommend for the laser treatments? Or who does your surgeon recommend?
 
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