Excision with Primary Closure
Complete excision of the pilonidal sinus with direct wound closure - achieving faster healing in selected straightforward primary cases when off-midline closure is achievable.
What is Excision with Primary Closure?
Excision with Primary Closure involves excising the entire pilonidal sinus and closing the wound with sutures at the time of surgery. When performed in the midline, wound breakdown rates are higher (up to 30%). Off-midline or asymmetric primary closure significantly improves outcomes - and is Dr. Samhitha's preferred approach when primary closure is selected.
At Lux Hospitals, Hyderabad, Dr. Samhitha Reddy performs primary closure pilonidal sinus excision for selected straightforward first-time sinuses where off-midline closure is achievable and adequate soft tissue is available. Patients who achieve primary wound healing benefit from significantly shorter recovery than open healing - making it an appealing minimally invasive pilonidal sinus treatment option.
Midline primary closure has a high wound breakdown rate and is not the recommended standard approach. Off-midline asymmetric closure significantly improves outcomes. For recurrent or complex disease, flap reconstruction is strongly preferred.
How the Procedure Works
Sinus Excision
The sinus, all pits, and tracts are excised completely. The excision is designed off-midline where possible to facilitate safer primary closure.
Wound Preparation
Thorough haemostasis and wound washout. Wound edges assessed for adequate tissue mobilisation for tension-free closure.
Deep Layer Closure
The subcutaneous deep layer is closed with interrupted absorbable sutures - eliminating dead space and bringing tissue edges together.
Skin Closure
The skin is closed with non-absorbable interrupted sutures or a subcuticular absorbable technique. A suction drain may be placed for 24 hours.
Post-operative Care
Sutures removed at 10-14 days. Activity restriction and avoidance of prolonged sitting for 3-4 weeks. Laser hair removal advised from 6 weeks post-surgery.
Outcomes
Who Needs This Treatment?
- →Faster healing than open excision - primary closure heals in 3-4 weeks
- →No need for daily wound dressings once closed - simpler post-operative management
- →Significantly better patient comfort than open wound management
- →Suitable for selected straightforward primary sinuses with adequate soft tissue
- →Day-care procedure under local or general anaesthesia
- →Off-midline closure approach at Lux Hospitals minimises wound breakdown risk
Primary closure, when it heals, offers patients a dramatically simpler recovery than open excision. The key is patient selection and off-midline closure technique - choose the right patient, close in the right plane, and the results are very satisfying.
— Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad
Excision with Primary Closure Cost in Hyderabad
The cost of excision with primary closure in Hyderabad depends on the extent of pilonidal disease, complexity of the condition, investigations required, and the care needed before and after surgery.
For patients with limited pilonidal disease, the approximate cost of excision with primary closure ranges between ₹35,000 and ₹65,000.
| Procedure | Approximate Cost Range |
|---|---|
| Excision with Primary Closure | ₹35,000 – ₹65,000 |
The final cost may vary depending on your individual condition, findings during evaluation, and whether any additional procedures are required.
Factors That Influence Excision with Primary Closure Cost
The overall cost may depend on:
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Extent of pilonidal disease: The size of the sinus, number of tracts, location of the disease, and presence of infection may influence the treatment approach and surgical planning.
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Pre-operative evaluation: Required investigations, clinical examination, and medical assessments before surgery may affect the overall cost.
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Additional procedures: If procedures such as removal of infected tissue, abscess drainage, or other pilonidal sinus management procedures are required, the cost may vary.
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Hospital stay and post-operative care: The duration of admission, wound care, medicines, and follow-up requirements may influence the final estimate.
Is Excision with Primary Closure Covered by Insurance?
Excision with primary closure may be covered by health insurance when it is performed for a medically necessary condition. Coverage depends on your insurance policy, inclusions, and approval process.
Our insurance support team can assist you with checking your policy coverage, required documentation, cashless approval process, and insurance-related queries before the procedure.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
During consultation, Dr. Samhitha Reddy, Proctologist and Colorectal Specialist in Hyderabad, will evaluate your symptoms, medical history, and investigation reports to determine whether excision with primary closure is suitable for you. She will explain the procedure, expected outcomes, and guide you regarding the estimated cost based on your individual condition and treatment requirements.
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Samhitha Reddy and get a personalised treatment plan.