A pilonidal sinus is a small cyst or tunnel in the skin, usually located near the tailbone at the top of the buttocks. It often contains hair, debris, and can become infected, leading to pain, swelling, and discharge. When conservative treatments or basic excision fail to provide lasting results, flap surgery becomes the most effective option for permanent relief.
Dr. (Maj)(Prof) Ravi Saroha, a senior plastic surgeon with extensive experience in complex wound closures and reconstructive techniques, offers advanced pilonidal sinus flap surgery in Delhi. His approach focuses on both curing the disease and minimizing the chance of recurrence.
In flap surgery, the entire infected sinus tract is surgically excised, and then a local flap of healthy tissue is rotated or shifted to cover the wound. This flap ensures better blood supply, tension-free closure, and a flatter contour of the natal cleft — all of which reduce the risk of infection and recurrence. Common types of flap techniques include:
Flap surgery is usually advised for recurrent, chronic, or complex pilonidal sinus cases where previous treatments like drainage or open excision have failed, or when the sinus is deep or multiple in number.
Unlike traditional open surgery, flap techniques close the wound using healthy, well-vascularized skin. This reduces healing time, keeps the area flatter (to avoid hair trapping), and drastically lowers the risk of the sinus coming back.
Most cases are done as daycare procedures, but in certain cases, you may be advised to stay for one night based on your general health and the complexity of the surgery.
You can return to basic daily activities in about 10–14 days, with complete healing in 3–4 weeks. You'll be advised to avoid sitting for long hours or strenuous activities during the initial days.
The recurrence rate after flap surgery is very low — significantly lower than with simple excision. Following post-operative instructions, maintaining hygiene, and keeping the area hair-free are key to long-term success.
