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Forum Name: Dermatology Topics

Question: Pilonidal sinus - Pre and Post surgery panics


 rocko_hunk - Sat Feb 06, 2010 3:12 am

Hi All,

I am about to go through Open healing "Pilonidal Sinus" surgery in a couple of days.. and I have Pre and Post surgery apprehensions.

Pre-Surgery:
1. What is the best way to get rid of the hair, around the infected region ?
2. What type of food should be taken before the surgery ?

Post Surgery:
1. How many days of Dressings is required ?
2. What are the diets to be maintained after surgery ?
3. How will it affect bowel movements, I heard the antibiotics are constipatory ?
4. Can I go to swimming after one month from the day of surgery
5. What is the best way to keep the treated zone.. hair free ?
6. Is it ok to survive on liquid diet for few days from day of surgery , to avoid any bowel movements
7. Since my work profile is desk oriented, will it increase the chance of recurrence ?
8. If so, how to avoid the recurrence ?

Thanks nd Regards,
~
 Dr.M.Aroon kamath - Tue Feb 09, 2010 5:06 am

User avatar Hi,
There are a wide variety of procedures for the management of pilonidal disease.

One may broadly classify them as
- 'open' methods
- 'closed' techniques(primary wound closure) and
- flaps (mainly for chronic/recurrent disease).

'Open' methods could be
- excision or
- excision and marsupialization.

Closed techniques may be
- midline closures or
- 'off-midline' closures.

In the 'open' methods, the wound is left open to granulate and heal(by secondary intention).This takes time and depends upon the three dimensional size of the wound among other factors.
Generally it may require about 4-6 months to heal completely, but on an average, the healing time is about 2 months.

It helps immensely in healing to keep the surrounding area free of hairs.There is no single recommended way of going about this.It perhaps does not matter so much as to which method is used as long as the surrounding area is maintained hair-free.

Dressings will be usually needed till completely healed.

As far as swimming one month after surgery goes, again, it depends on the perceived rate of healing and the operating surgeon's preferences.

Unlike surgery for ano-rectal fistulae and hemorrhoids, the 'raw area' after a pilonidal sinus surgery is generally not too close to the anal orifice and therefore one may not need to worry too much about bowel movements following surgery and wound contamination.

Prolonged sitting, associated with vibration (jolting) certainly increases the risk of pilonidal disease (sitting at work alone, may only increase the risk marginally).

The main ways to reduce the chances of recurrences include
- meticulous local hygiene &
- keeping the area free of hairs.
Good luck!

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