✦ OPEN HEALING TECHNIQUE

Excision with Open Healing

Q: How long does the wound take to heal?

The wound typically heals over 6–8 weeks with daily dressings and sitz baths. Healing is gradual but usually complete with consistent wound care.

Q: Will I need help with dressings?

Initial dressings are done at the clinic. Many patients learn to do simple home dressings, while some prefer continued nurse-assisted care. Both approaches work well.

Q: Can I return to work during healing?

Most patients return to office work within a week. Avoiding prolonged sitting, heavy lifting, and ensuring regular dressings supports smooth healing.

Q: Is open healing better than primary closure?

Open healing has a lower recurrence rate compared to simple midline primary closure but takes longer to heal. Off-midline flap techniques (Karydakis, Limberg, Bascom) combine the best of both approaches.

Complete surgical removal of the pilonidal sinus with the wound left open to heal naturally from the inside out — minimises recurrence with structured wound care.

30–60 min PROCEDURE

Day Care – 1 Day HOSPITAL STAY

>85% SUCCESS RATE

1 Week RETURN TO WORK

What is Excision with Open Healing?

Excision with Open Healing is a well-established technique for pilonidal sinus disease in which all diseased tissue is completely excised and the wound is intentionally left open to heal naturally from the inside out. While healing takes longer than primary closure, this approach has the advantage of minimising recurrence by allowing complete healing without trapped pockets. Structured wound care, regular dressings and hygiene are essential to good outcomes. Dr. Tejasree Vengala performs excision with open healing at Lux Hospitals, Hyderabad, in selected patients where it offers the most reliable long-term result.

Suitable for patients with primary or moderately complex pilonidal sinus disease who can commit to structured outpatient wound care, or where primary closure is not advisable due to infection or tissue concerns.

How the Procedure Works

Anaesthesia & Examination

Surgery is performed under spinal or general anaesthesia. The full extent of the disease is mapped using probes and methylene blue if needed.

Wide Excision

The entire pilonidal sinus, all tracts, and surrounding unhealthy tissue are excised completely down to healthy fat or fascia.

Wound Inspection

The wound is carefully inspected to ensure no diseased tissue is left behind, and any small bleeding points are controlled.

Open Wound Management

The wound is left open and packed with a simple dressing. Patients are given clear instructions on dressings and sitz baths.

Discharge & Wound Care

Most patients are discharged the same day or next, with structured outpatient wound care visits over the healing period.

Outcomes

30–60 minDURATION

Day Care – 1 DayHOSPITAL STAY

>85%SUCCESS RATE

6–8 WeeksFULL HEALING

Who Needs This Treatment?

→Lower recurrence than midline primary closure
→Complete removal of all diseased tissue
→Day-care or short-stay surgery
→Allows healing without trapped pockets
→Reliable option in moderately infected cases
→Predictable long-term outcomes with good wound care

Open healing is patient and slow, but it is honest — every layer of the wound heals on its own, with nothing hidden. For carefully selected patients who commit to good wound care, it gives durable, predictable results.

— — Dr. Tejasree Vengala, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

How long does the wound take to heal?+

Will I need help with dressings?+

Can I return to work during healing?+

Is open healing better than primary closure?+

Not sure which treatment is right for you?

Book a consultation with Dr. Tejasree Vengala and get a personalised treatment plan.

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