FAQ - Surgery Aftercare

"How soon can I get back to sports/working out?"

That depends on how big your wound is, which method of healing you are using and your own common sense. What you DON'T want to do is do things that are going to disturb the mending tissue in your wound during the first 4 weeks. If there is a high probability that you might fall and hurt your tailbone area, then you shouldn't be doing it.

Bike riding is good (on a quality saddle that takes pressure off the tailbone, not those wide granny seats on bikes at the gym. And no sitting upright on the seat, lean forward.)
Yoga is good.
Gentle weightlifting is good, just remember that heavy lifting causes tears in your muscle tissue which the body has to mend at the same time as it's mending that big wound on your behind.
Most of all, be sensible and listen to your body - if something hurts, stop doing it!

It will also depend on your tolerance for risk. Many people's willingness to risk infection/recurrence is less than zero, which means open healing and no activity that might affect that nice, new healthy tissue filling in the wound...

"Can I go swimming while I'm healing?"

The official line on this is NO for pools and/or lakes (icky things in the water + open wound = infection) and POSSIBLY for ocean. If you have an open wound, be smart. Salt water is good for wounds, but how clean is the water at your beach, really? We've had some doctors give the green light for ocean swimming and some say to not risk it. The one thing all agree on is NO POOLS.

"Explain this Packing thing?"

For people having open healing, you get a lovely 8 weeks of packing the wound while it heals. Packing is an overview term for the cleaning and dressing of the wound. At least twice daily you will need to flush the wound out with either water or saline to remove debris and dead tissue from the healing process. After flushing the wound, you will insert a lightly moistened piece of gauze inside the wound to keep the sides from touching each other and mending together. Fold the piece of gauze over at least once but don't make it so bulky that it hurts when it it's in there. Then put another piece of gauze or pad over the top to cover the wound and tape it down.

"I had no pain for the first few days after surgery but now here on day 4/5 IT HURTS!"

Normally, the most painful period is the first 4 to 5 days after surgery due to the inflammation of the wound area by natural body reaction to injury. To help patients through this immediate post-surgery pain, some surgeons use a long-acting anesthetic in the surgical wound. This deadens the nerve endings for several days and it generally wears off right about the same time the inflammation is subsiding, although you still will get a little bit of the pain as the anesthetic wears off. Be happy that you missed those first couple of days! Remember to take your pain medication when you start to feel the slightest twinge of pain during this period. Pain meds work better when taken before you are seriously in pain. If you are on day 5 and the pain is actually increasing and continues to increase into day 7 after surgery, get in to see your doctor ASAP.

"Why isn't my wound healing?"

The possibilities:

Not enough oxygen is getting to the wound bed. This is the single biggest problem with Pilonidal surgery, the placement of the surgical wound in a location that gets very little air and too much moisture/debris. Lack of oxygen slows wound healing and provides a happy home for anaerobic bacteria, which can keep wounds open for years in this part of the body.
There is an infection present. An infection can come from several sources: debris/hair in the wound bed, a sinus that was missed during surgery or the surgeon not removing all the infected tissue. Don't mess with surgical wound infections, they can lead to Sepsis, which can be fatal if left untreated. See a doctor immediately. Infection is usually accompanied by pain, swelling, fever and foul odor.
You are either healing slowly because of nutritional deficiencies, undiagnosed diabetes, or an impaired immune system.

"My wound isn't healing and my doctor can't figure out why"

Much as we love them, a surgeon specializes in cutting; healing wounds is not their specialty. The next best step is to find a Wound Healing Center, most larger cities have them. Call your local hospital to find the nearest one. Wound care centers specialize in healing difficult wounds, it's all they do, and they are on the leading edge of wound management, which your surgeon probably isn't. We usually advise people to find a Wound Center if they are still unhealed after 3 months.

"Should my scar hurt and itch?"

After your wound has healed the new tissue will be very fragile for a year or longer. You can use topical anti itch creams, vitamin E, vitamin K or antibiotic ointment to help soften the scar and make it less irritable. It is important to watch how much pressure you put on the scar, many people experience slight discomfort when sitting for several months even after their wound has healed - a coccyx cushion is the answer. We also advocate swabbing the wound area once a week with No Bump RX to keep any inflammation at bay after you are fully healed.

"Hair Removal....HELP!" - See the Hair Removal page.

Also see the rest of the Aftercare section...

This page last updated: 10/28/2010

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