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

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. In more severe cases, the packing is changed at 48 hours by a family member or a visiting nurse. You will initially be prescribed a one week oral antibiotic course, which will later be tailored following wound culture results.

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

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, 2-3 days absence should suffice.

How do I care for my wound following pilonidal cystectomy?

The gauze bandage on the wound is removed after 48 hours and the wound is then cleansed with soap in the bath or shower. The wound is patted dry, and both the wound and the drain are repeat bandaged in the same way with prescribed gauze supplies. This is continued on a daily basis for 2 weeks, or until drain removal, after which point the wound may be left open to air.

Will there be a drain in place following surgery?

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 1-2 weeks depending on the volume of drainage.

Is sitting discouraged following pilonidal cystectomy?

Sitting is permissible, however, periods of prolonged sitting (2 hours or more) are 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.

Is pain severe following pilonidal cystectomy?

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.

Travel Tips for Pilonidal Patients - Pilonidal Treatment Center of New Jersey

Travel Tips for Pilonidal Patients

A diagnosis of tailbone-area pilonidal disease has been established and you wish to avoid surgery. How do you travel safely with the lowest risk of a flareup?

When sitting for a prolonged period of time , either in a car, airplane, or even waiting in the airport, be sure to sit on an ergonomic coccyx pillow to offload pressure from the tailbone (sacrum) and bottom tip of your spine (coccyx); the best coccyx pillows distribute heat effectively. Here is one I have used on patients before with success and nice feedback https://ergonomiclux.com/products/gel-memory-foam-coccyx-seat-cushion?currency=USD&country=US&variant=48802142847253&utm_source=google&utm_medium=cpc&utm_campaign=Google%20Shopping&stkn=ca75f35a3a15&gad_source=1&gad_campaignid=23178920563&gbraid=0AAAAAqD1WvsVe4ry1snxXiDQ-by47iMY3
Be sure you break up your continuous sitting intervals into no more than 2-hour increments. This may mean intermittently walking the aisle of your airplane, pulling into an automobile rest stop for a bathroom break, or walking the airport terminal for a coffee.
Listen to the cues your body may send you such as pain or itchy discomfort in a certain sitting position or on a particular sitting surface…. Adjust accordingly!
Be established with a reputable dedicated pilonidal specialist who is generally reachable during business hours through phone or e-mail, including an ability to send images of any area of concern. If a pilonidal abscess is developing , this relationship could be the difference between a wait-and-see approach only and an appropriately proactive antibiotic prescription and further guidance, particularly if you are remaining within the continental US. At PTCNJ, for patients leaving the continental US, we have even provided patients with a short antibiotic course and an abscess drawing salve just in case a pilonidal abscess is seen to be brewing…the advantage of an established relationship with a pilonidal specialist!
Try to shower twice per day and always after the beach. Optimally, after the beach/ocean, a hot tub with or without Epsom salts is a nice option to have if possible. “Epsom salts” by the way is achieved by dissolving 1-2 cups of magnesium sulfate in the warm bath water.
Avoid tight fitting pants or swimwear for a prolonged period of time.

Travel Tips for Pilonidal Patients

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Travel Tips for Pilonidal Patients

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