Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • severe/uncontrollable pain unresponsive to first-line management
  • suspected acute pilonidal abscess

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network


Regional Health Networks

Barossa Hills Fleurieu Local Health Network

Eyre and Far North Local Health Network

Flinders and Upper North Local Health Network

Limestone Coast Local Health Network

Riverland Mallee Coorong Local Health Network

Yorke and Northern Local Health Network


Exclusions

  • asymptomatic pilonidal sinus

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • persistent pilonidal sepsis

Category 2 (appointment clinically indicated within 90 days)

  • chronic pilonidal disease with or without recurrent infection or abscess with impact on acts of daily living /employment

Category 3 (appointment clinically indicated within 365 days)

  • chronic pilonidal sinus

For information on referral forms and how to import them, please view general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • cultural considerations
  • age
  • past medical/surgical history
  • medications and dosages
  • allergies and sensitivities
  • height, weight and body mass index (BMI)
  • smoking, alcohol and other drug use
  • onset, duration, and progression of symptoms
  • presenting symptoms
    • pain, swelling, and redness of the overlying skin
    • painless lump (cyst)
    • presence of discharge (indicating sinus)
    • previous management trialled and outcomes
    • social and emotional impact e.g. acts of daily living/employment
  • examination findings
    • associated cellulitiS
    • enlarged inguinal glands or lymph nodes
    • presence of discharge indicating sinus
    • systemic symptoms such as fever, malaise or nausea
    • tender lump with/without overlying erythema (abscess formation)
    • visible or lumpy tracts in those with chronic or recurrent disease
    • relevant diagnostic/imaging reports, including location of company and accession number

Clinical management advice

The management of a pilonidal sinus typically involves a combination of conservative measures, minimally invasive procedures, and surgical intervention. The specific treatment approach may vary depending on the severity of the condition and the individual's symptoms.

Community management for pilonidal sinus may include:

  • hygiene management to ensure the area remains clean and dry
  • applying warm compress to reduce pain and promote drainage
  • avoid prolonged sitting to offload the area
  • encourage regular analgesia to reduce pain and discomfort
  • consideration of laser hair removal

The choice of treatment depends on factors such as the extent of the sinus, the presence of infection, recurrence rates, and individual patient factors. Follow up review is advised for ongoing assessment and monitoring.

Clinical resources

Consumer resources