Umbilical Pilonidal Sinus Abscess with Instillation NPWT

Objective

This case presents the use of Polyhexanide + Poloxamer solution with instillation NPWT in the management of an umbilical pilonidal sinus abscess. The objective was to support abscess cavity cleansing, infection control and wound preparation before primary suturing.

Case Summary

A 15-year-old male patient, referred from another center and without reported comorbidity, presented with redness, pain, discharge and odor in the inferior umbilical region. Wound culture was obtained and MRSA growth was reported.

The patient was diagnosed with umbilical abscess. A 3 cm incision was made approximately 2 cm below the umbilicus, and about 250 cc of abscess content was drained. The cavity was then washed with Polyhexanide + Poloxamer solution.

Wound Care Method

• Wound culture was obtained before treatment planning.
• MRSA growth was reported in the wound culture.
• Umbilical abscess was diagnosed.
• A 3 cm incision was made below the umbilicus.
• Approximately 250 cc abscess content was drained.
• The resulting cavity was washed with Actolind® Solution Plus.
• Instillation NPWT was applied using Actolind® Solution Plus.
• The instillation cycle was reported as 10 cc per hour, 2-minute dwell time, then withdrawal.
• Dressings were renewed every 3 days.
• After infection control, primary suturing was performed.
• Actolind® Gel Plus was recommended for daily pressure dressing after discharge.

Clinical Follow-up

During follow-up, instillation NPWT was continued with scheduled dressing renewals every 3 days. On day 9, no infection signs were observed and culture was reported as negative. Primary suturing was then performed with 2.0 prolene.

Outcome

The case documentation reported complete wound improvement after the use of Polyhexanide + Poloxamer instillation NPWT and subsequent primary suturing. The patient was discharged with daily Actolind® Gel Plus pressure dressing recommendations.