Treatment after pilonidal surgery
Adequate postoperative treatment is an essential complementary part of any pilonidal operation. Lavage of operated site, bandage and local hair removal, should continue under close observation of the treating surgeon, until complete healing of wounds is achieved
The following recommendations apply to patients after minimal surgery and to those after wide excision operations (open and closed). Obviously, instructions of the treating surgeon have priority over the following.
Principles of self-care after Pilonidal surgery:
1. Wash operated area with running tepid water and regular soap about twice daily, starting on the day after the operation. The lavage is best done in a mild squatting position, using a mild water current from a shower handle.
Postoperative gluteal cleft dressing
2. Operated site must be constantly dressed. A few simple dry gauzes, 10X10cm in size, should be folded in the middle and placed along the bottom of the natal cleft. Adhesive tape should be applied to keep the gauze in place. The purpose of the bandage is to absorb operative secretions. Also, by separating the buttocks apart, the bandage enables ventilation of the wounds and free drainage from underlying cavities. The dressing also prevents penetration of hairs into the fresh wounds which can possibly cause a persistent disease.The bandage should be worn continuously, 24 hours a day (except when washing).
3. Hair removal in the surgical area: Some patients will require hair removal in the surgical area throughout the recovery period. The need for this will be determined individually during the first post-operative check-up.
When hair removal is required in this area, it is recommended to use tweezers or a hair removal cream (for delicate skin) once or twice a week. Regular shaving is difficult and ineffective in this area.
After recovery is complete, laser hair removal treatments may reduce the rate of recurrence, according to preliminary findings from studies.
4. Postoperative pain treatment : In the event of postoperative pain, you can take Optalgin or paracetamol – up to 4 tablets a day.
In the case of more severe pain, painkillers from the ibuprofen family (such as Nurofen, Advil, Addax) can be used, as long as there is no known sensitivity or allergy to any of the preparations.
5. Return to activity: You may return to your normal daily activities after treatment. However, you should avoid sports, running, swimming in the sea, pool or mikveh, as well as riding a motorcycle, bicycle or horse until you have fully recovered.
6. Warning signs: If any of the following symptoms appear in the days following surgery – fever above 38 degrees, increasing pain, swelling in the surgical area, or bleeding that does not stop with a thick bandage and local pressure – you should seek urgent medical advice from your surgeon as soon as possible.
7. Check-ups and follow-up care: It is very important to arrive for check-ups on the scheduled date. During the check-up, signs of inflammation are checked, hairs that may penetrate the surgical wounds are removed, and follow-up instructions are updated according to the state of recovery.
Important: Patients who do not attend follow-up examinations or do not strictly follow the instructions in full –
May suffer from poor recovery and recurrence of the disease.
