Q: What should I expect after incision and drainage of a pilonidal abscess?

A: The abscess cavity is usually filled with a 1/4″-wide packing strip. This packing may be self-removed in the tub or shower at 48 hours. The small wound is then left unpacked to heal from its depths outward.You will initially be prescribed a one week oral antibiotic course, which will later be tailored following wound culture results.

Q: How much time should I take off from work following pilonidal surgery?

A: Following pilonidal cystectomy, you should plan for a 2-3 day absence from work or school. If your duties mandate prolonged sitting, or heavy lifting, 1-2 weeks of leave is preferred. If only an incision and drainage has been performed, a one day absence should suffice.

Q: How do I care for my wound following pilonidal cystectomy?

A: The gauze bandage on the wound is removed after 24 hours and the wound is then cleansed with soap in the bath or shower. The wound is patted dry, and then left unbandaged, with the exception of the drain sponge and the small glued tape strips  The strips will naturally fall off in several weeks, and may become wet in the bath or shower.

Q: Will there be a drain in place following surgery?

A: A small drainage tube is left deep to the wound to prevent fluid accumulation. This is connected to a bulb, which is often safely pinned to the underwear. The drain is emptied several times a day. It is generally removed at home by a family member at one week following surgery.

Q: Is sitting discouraged following pilonidal cystectomy?

A: Sitting is permissible, however, periods of prolonged sitting of 2 hours or more is discouraged for 2 weeks following surgery. A “donut” type cushion, available at most medical supply stores, is highly recommended to offload pressure from the surgical site. The cushion is best brought with you to the surgical center to be first used on the car ride home.

Q: Is pain severe following pilonidal cystectomy? 

 A: The pain is usually not severe following this procedure. We do medicate with routine ibuprofen, and as-needed opiate analgesic. The area will likely be numb for several weeks and this will gradually resolve.


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