Pilonidal disease is a chronic infection of the skin in the region of the buttock crease. The condition results from a reaction to hairs embedded in the skin, commonly occurring in the cleft between the buttocks. The disease is more common in men than women and frequently occurs between puberty and age 40. It is also common in obese people and those with thick, stiff body hair. Pilonidal disease is a disease of young people, usually men, which can result in an abscess, draining sinus tracts, and moderate debility for some. This is a condition dealt with by general practitioners, accident and emergency departments, general surgeons, colorectal surgeons, plastic surgeons, district nurses and wound-care specialists. It is an unglamorous condition that, despite its prevalence, seldom achieves priority within a busy clinical practice. However, its complex debilitating nature and negative economic effects for the predominantly affecting the young working population should not be underestimated.The primary goal of this book is to remain for all the time the most thorough, useful, readable, and understandable handbook presenting the pilonidal sinus disease. It is designed to be equally useful to students, trainees, and experts in the field. It remains a discipline in which the knowledge and skill of a surgeon combine for the welfare of all patients.This book contains seven chapters, of which the first five elaborates etiology, pathogenesis, presentations of the disease, conservative management and surgical options for sacrococcygeal pilonidal sinus disease while the sixth chapter briefs about post operative care and nursing management of the patients of pilonidal sinuses and the last chapter describes the other uncommon but important sites of pilonidal disease as well as complications attendant to the disease. Adequate illustrations have also been inserted with regard to specific presentations and treatment options appropriately. As its title indicates, this book is neither a fully detailed textbook on pilonidal sinus disease for the novice nor a comprehensive reference for the expert.Emphasis is placed on readily understandable descriptions of diagnostic and therapeutic procedures, accompanied by explanatory schematic drawings as well as pictures of the described text. A useful short glossary is also provided. Each chapter starts with key summary points and ends with summary points and adequate references. Several color plates are also provided, although the majority of the book is otherwise illustrated with occasional black and white diagrams.The chapters are well-structured throughout, with good use of tables, illustrations and summaries, to facilitate an easy dip into the subject. References at the end of each chapter are useful for those wanting to learn more about the areas covered.Nonetheless, in contrast to many standard surgical textbooks this small volume is clearly international in its perspective. It will be apparent to the reader that patient management in several areas of pilonidal surgery may still differ widely from region to region even in our ever more interconnected world, yet each chapter has been written to assess rigorously the level of evidence upon which operative and nonoperative treatment recommendations are made. As the quality of available evidence advances in a number of surgical areas, the author believes that clinical management will perforce and become more uniform in most countries. The author plans to update this small volume frequently so that its readers can be assured of an accurate assessment of evidence based surgical practice to keep pace with the advancements in technologies and techniques.
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