Pilonidal Support Alliance

Information, treatments, and support for Pilonidal Disease patients and medical professionals

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Be Ready. Feel Confident and Informed

Surgery day can feel overwhelming, but good preparation helps you feel more in control. This guide covers prehab (getting your body ready), practical checklists, and what to expect — so you can face surgery with confidence.

Prehab – Preparing Your Body for Surgery

Why Prehab Matters
Just like athletes train before competition, you can “train” your body for surgery. Getting healthier—even in small ways—can help you:

  • Recover faster
  • Lower infection risk
  • Feel stronger during healing

Surgery is traumatic, from both a physical and psychological perspective. When you are experiencing health problems, life can feel very out of control. Little things like preparation can help ease the anxiety that always accompanies a trip to the operating room.

4–6 Weeks Before Surgery (Even 1–2 weeks can help)

Gentle Physical Activity

  • Aim for 20–30 minutes most days if you can.
  • Daily walking or light stretching improves circulation and lung function.

Nutrition Boost

  • Eat more lean proteins (chicken, fish, eggs, beans) to support tissue repair.
  • Add colorful vegetables and fruits for vitamins that aid healing (especially vitamins C & A).
  • Stay well-hydrated — aim for 6–8 glasses of water daily.

Quit or Cut Back Smoking & Vaping

  • Even 2–3 weeks of smoke-free can significantly improve wound healing.
  • Ask your doctor about nicotine replacement if needed.

Sleep Well

  • Target 7–9 hours of quality sleep to help your body repair and regulate inflammation.

Practice Core Strength & Mobility

  • You’ll be moving around a lot less during recovery, so build a strong foundation to recover from.
  • Gentle seated leg lifts, side stretches, or light yoga can make moving after surgery easier.
  • Focus on positions you may need after surgery (e.g., getting up from a chair without straining).
  • Flexibility stretches are an excellent idea, as you’ll be twisting your upper body to look at your surgical site fairly regularly during recovery.

Pro Tip:
If you have chronic health conditions (like diabetes), work with your doctor to optimize them before surgery—controlled blood sugar significantly reduces infection risk.

The Week Before Surgery

  • Confirm surgery time, location, and transportation to and from the hospital/surgery center.
  • Review instructions for when to stop medications or other supplements, as some can interfere with anesthesia or blood clotting.
  • Review any fasting, bowel prep, or skin prep instructions.
  • Pick up post-op wound care supplies:
    • cotton gauze pads
    • first aid tape (hypoallergenic is best)
    • rubbing alcohol
    • cleansing products
    • scissors (if you don’t have any)
    • small free-standing mirror
    • Q-Tips
  • Arrange caregiver help for at least 48 hours after surgery so you don’t have to prepare meals.
  • Prepare loose, comfortable clothing for surgery day. You’ll be coming home with a lot of bandaging on your tush. Assume you might not be able to wear underpants. TL;DR sweatpants for the win.
  • Confirm time off with your employer. You’ll be in recovery for at least one week; two would be even better. You won’t be able to sit for the first week, so don’t expect to get back to work right away.
  • Pay bills and run any other errands. You won’t be able to drive for 4-5 days after surgery because you’ll be on pain medication.
  • Purchase groceries and pet food for at least a week, or arrange delivery so you don’t have to worry while you are healing. Did you remember toilet paper?
  • Consider getting a Coccyx Cushion for sitting once you are able.
  • If having surgery with open healing, make sure you have a hand sprayer for flushing out the wound bed.
  • Review the vitamin and nutrition guidelines for optimal healing.

A Good Idea

Advance Directives

Advance Directives are legal documents that let you share your healthcare wishes if you can’t speak for yourself during treatment. Your hospital/surgery center will probably ask if you have one.

Even for minor surgery, having one ensures your care team and loved ones know your preferences. If you are an organ donor, make sure your family knows.

Tip: Share a copy with your surgeon, your primary doctor, and the person you’ve chosen to make healthcare decisions on your behalf.

The Day Before Surgery

  • Follow any specific prep instructions from your surgeon.
  • Eat a light, healthy dinner unless told otherwise.
  • Drink plenty of water; anesthesia can cause dehydration.
  • Pick up pain medication, and make sure the doctor’s office called it in.
  • Pack your bag:
    • ID and insurance card
    • List of medications (anesthesia team needs to know)
    • Small pillow or cushion for the ride home
    • Phone charger
    • Slip-on shoes
    • Double-check transportation plans.

What to Expect at the Facility

  • Check-in: Paperwork, ID verification, and consent forms.
  • Pre-op prep: vital signs, IV placement, anesthesia team visit.
  • Support person: Usually allowed to stay until you go to surgery.
  • Recovery area: Nurses monitor you as you emerge from anesthesia before discharge.

Bring a trusted friend or family member to hear and remember post-op instructions. You’ll still be coming out of anesthesia and probably won’t remember them.

Go Here Next:

Anesthesia

You’ll be happier on surgery day with some really, really good drugs. What to discuss with your anesthesiologist.

Insurance

For US-based patients, some advice on working with insurers and the usual billing codes. Make sure your surgery is covered.

Post-Surgery Tips

Going home from surgery and managing your first days at home post-surgery, especially when going to the bathroom.