The indication for pilonidal abscess/sinus excision is a pilonidal sinus and/or abscess. A pilonidal sinus is a small opening or tunnel under the surface of the skin. It occurs in the cleft at the top of the buttocks and can extend down to 5 cm above the anus. A pilonidal cyst usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. Fluid or pus may accumulate inside of it, causing the formation of a cyst or abscess.
It is treated by removing the affected skin and involved tissue and closing the resultant defect with stitches, a surgical drain will be placed to encourage wound healing and prevent accumulation of fluid in the cavity left by the excision. If there is associated infection or an abscess it may be dangerous to close the wound and it is then first drained by a simple operation (refer to abscess drainage information sheet) and then later completely excised once the infection has settled. It may be necessary to leave the wound open and allow it to heal up over a period of 4 to 10 weeks. The length of time taken for healing depends on the size the wound. If the wound is left open it may require daily dressings initially. These will be arranged for you.
Complications are seldom serious, and include the following:
- Delayed healing is the main problem, especially when the wound is not sutured and deliberately left open. It can take a month or two to heal gradually.
- There may be a recurrence in about 10% of cases.
After your consultation:
- Obtain authorization from your medical aid and book your bed for your hospital admission.
- Carefully read through pre-operative information provided.
Day before surgery:
- Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).
Day of surgery:
- Arrive for admission at indicated time on ‘Code & Consent’ sheet.
- Change into theatre attire, remove all valuable belongings.
Approximately 30-45 minutes.
Duration of hospital stay:
- Usually 1 – 2 days (dependent on post-operative progress of patient and extent of the infection).
- You will receive a wound care pack from the pharmacy upon discharge, you will be informed of how to take care of your surgical drain before your discharge.
- Refrain from strenuous activities (incl. exercise) for at least 4 weeks post-operatively.
Back to work:
- Sick leave required post-operatively is approximately 7-10 days in total, due to surgical drain.
Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:
- Warming devises in theatre as well as warm intravenous fluids.
- Intra-operative pain medication through the drip.
- Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
- As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.