Pilonidal Sinus: Care and Dressings

What is a pilonidal sinus?

Pilonidal sinus disease is a condition where the surface and shallower sections of the skin become inflamed. This most commonly occurs on the skin near your/your child’s bottom but can also occur in other areas such as the armpit.

It is commonly agreed that the disease is caused by body hair being pushed into the skin causing a small hole, which can pick up more hair and dead skin cells. This can then cause inflammation and a small tunnel. This can then become infected. Surgery is required to clean the tunnel out.

You are receiving this leaflet as you/your child has had this surgery, and the community children’s nursing team have been asked to look after the wound at home.

Our team will regularly check the wound, clean it, and dress it for you/your child.

What will your community children’s nurse do to help the wound to heal?

The community children’s nursing team will assess the wound the day after surgery and identify how often they need to see you/your child in the community each week for dressing changes. This is usually daily to start with and then this will change to every other day and then twice a week as the wound heals.

The community children’s nursing team will oversee the healing of the wound in the community until it has fully healed.

Our team will also request all required dressings through the GP practice.

If the visiting nurse has concerns about the wound (for example if it is infected), they will speak with the GP or with the surgical team to address this. If you/your child needs to see a doctor they will organise for you to attend Kingfisher Ward.

How can I prepare for the visit?

We recommend taking off the dressing and taking the opportunity to shower immediately before our visit. Please do not direct the shower head towards the wound or clean inside the wound during the shower. We will clean the wound for you/your child. We request a parent/carer to be present during our visits

Ensure to take/provide your child some pain medicine at least half an hour before our visit if the packing or cleaning of the wound is uncomfortable. Paracetamol or ibuprofen can be brought in the local shop.

What can be done at home to support wound healing?

Movement
It is ok to stay a little active whilst the wound heals. This is good for wound healing and to reduce stress. For example, going on a light walk. However, we would recommend no excessive exercise or activity that places stress on the wound such as sports and excessively hilly walks until the wound has healed.

Sitting
Sitting for long periods should be avoided as this places pressure through the wound. Try to lay on your/your child’s side where possible. When you/your child returns to school, the community children’s nurses can speak with school about how to protect the wound.

Keeping the wound clean
Please ensure to wipe away from the wound after a poo (bowel movement) to keep the wound clean. The community nurses may need to shave body hair at the wound edges if it is too long and sitting in the wound. Consider permanent hair removal long term. Avoid baths until healed. Shower on the day of our visit.

Eating and drinking
Ensure to drink plenty of water during the day to help with healing. Ensure to eat a well-balanced diet high in protein.

Additional lifestyle factors
If you/your child smokes or vapes, please consider stopping. The NHS website has lots of information to support through this: https://www.nhs.uk/live-well/quit-smoking/nhs-stop-smoking-services-help-you-quit/ Drinking alcohol can also slow wound healing and we would encourage you/your child to stop if this occurs. Let the community children’s nurses know if you/your child are on any medication such as steroids or immunosuppressants, as we will need to consider stopping them.

Watch out for signs of infection

Immediately update your community nurse if:

• New or increased pain at the site
• Skin around the wound feels hot to touch
• Skin around the wound is swollen
• New redness at the wound edges and surrounding the wound
• Changes to usual skin colour around the wound
• New bad smell coming from the wound
• Feeling tired or like having the flu.

Contact details

We hope this information has been useful. Any questions, please contact us below:

Team office phone: 01305 254279

Team email address: ccndorchester@dchft.nhs.uk

Address: Community Children’s Nursing Team,
The Children’s Centre
Dorset County Hospital
Dorchester
DT2 9UY

Working hours: Monday to Friday, 9am to 5pm (excluding bank holidays).

Please note: We are NOT an emergency service.

We have an answerphone which is checked twice daily during working hours.

If your contact is urgent, please contact the Paediatric Assessment Unit out of hours on 01305 254218 or Kingfisher Ward on 01305 254253.

Useful websites

NHS website – pilonidal sinus: https://www.nhs.uk/conditions/pilonidal-sinus/

Wessex Healthier together: https://what0-18.nhs.uk/

NHS website – stopping smoking: https://www.nhs.uk/live-well/quit-smoking/nhs-stop-smoking-services-help-you-quit/

Patient experience

Patient and family feedback is extremely important to our service and we value hearing from you: https://dchft.onlinesurveys.ac.uk/paediatric-specialist-and-community-nurses-questionnaire

About this leaflet

Author: Beth James, Community Children’s Nurse Specialist Practitioner
Written: May 2025
Approved: October 2025
Review date: October 2028
Edition: v1

f you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk