My experience with open excision

#1
I figured I would make a thread about my experience with Pilonidal excision left open in case people wanted to know more about it, or are on the fence with different types of surgery and wanted to know more.

Before the surgery I was told everything was going to be fine, it is a minor surgery and I will be back to work in 2 to 3 weeks. (They knew full well I work for a cable company so I climb, lift and have to distort my body sometimes.) They never mentioned how deep the wound would be, the didn't tell me I should probably wait and bank more sick time either. All in all I was left in the dark so I have to say, ask as many questions about the procedure you are getting as possible so you can make sure everything in your life is in order, relationships, work life, your own well being, etc, etc. I cannot stress that enough. Had I know I would have waited another year or 2 and banked sick time so I could take 2 months or so off.

My surgery was on December 14th, roughly a 2.7 (7cm) inch deep wound, about 2.5 inches long and 1 inch or so wide. (My numbers might be a bit off, I cannot remember fully, I posted in other posts about it so they might not be the same. lol all I know is it was big.). I was discharged but I have to have home care every single day.

The problem with it was not pain, I never had any and still haven't. I was given T3's that I still haven't touched. The issues I had was discomfort. It took about a week and a half for me to be able to actually sit for an extended time. I am not really leaking all that much, the wound is in great condition as far as a wound can be. I have been able to do moderate work outs (which sucks because I do Karate and having to wait for this to heal is terrible.) and my mobility is getting better all the time, I can bend down, kneel, etc, etc, just fine I just can't sit on the ground yet.

It has been 14 days since the surgery, my wound is about .7 of an inch now, length has changed a bit albeit slowly because of the packing and width has only decreased a little bit again due to packing. The depth is the big deal here, they anticipate I will be off packing in a week or so maybe less because of how fast it is healing and in the proper state. Which means I will only need home care every 2 or 3 days, it will basically be cleaning the area and slapping on a new bandage.

The only issue's I have now is work, I have to go back Jan 2 and I cannot extend sick leave as I have no sick days left, I do however have some personal leave days (6) so I am going back for the first week for half days. I see my surgeon on Jan 3. The other problem is the antibiotics, they have given me a few side effects which if that's the only complaint then I am doing pretty good. I have about a day and a half left then I am done with them.

All in all, healing is going very well, I am starting to feel like myself again and I anticipate mid January to early February I will be back to normal, or at the very least the wound will be closed and I can pick up my pace (No overdoing it, I know I will have to modify work and my karate but at least I will hopefully be able to do some of them.). I think a lot of my reasons for this is that the wound is higher on my back and it is not on the mid line which seems like the most difficult area to heal.

If anyone has any questions, feel free to ask. I hope this can help some people figure out their course of action so they can be free of this issue.
 
#2
I figure I would give an update to this story.

It's been 20 days now since I had my surgery. I still have to have a nurse come everyday to replace the bandage and packing. I just had it done by a nurse I haven't seen in more then a week and she said I was making really good progress despite "It being the largest incision left open she has ever seen.". I didn't like hearing that but whatever, it is what it is.

Either way, I am back at work on half days, I did leak completely through the bandage and my pants (beige work pants no less) but the bandage and packing hasn't been changed in well over 24 hours so I wasn't shocked.

I was able to sit through the new Star Wars movie in theaters (it was over 2 and a half hours) with no issues aside from having to readjust myself a few times. No leakage was showing in the bandage after that long of a time sitting.

No pain still which is great, I can sit just fine but I can't have any extra weight on me, basically my dog or wife can't lean on me while I am on the couch. I can sleep on my back but its uncomfortable. I can crouch, bend and get down on the ground so much easier. I can get in and out of vehicles a lot easier and I can't really say I have any main issues.

Measuring day should be tomorrow so if they do it I will post the results. The only major complaint I have is with my surgeons office. I was told he needed to see me 2 to 3 weeks after the surgery which would have been Jan 3rd, they called me and pushed me back to Jan 16th, its around 33 days AFTER the surgery which seems like a very long time and it's bugging me. I will deal I suppose, I am off of antibiotics so I feel good, so I will just see where this goes.

Thanks for listening, even if no one ever replies it still makes me feel a lot better (less alone) knowing people have read my story and I hope that it can at least help people seeking different experiences. Take care everyone!
 
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#5
Thank you both for reading.

They still have not measured the wound so I can't give updates on the size yet. Yesterday a nurse said the tunnel is very very shallow so I have to be close to not having to pack it anymore. The wound still is in great shape and everyday they seem to say "Oh, new skin has formed!" so its starting to close length and width wise which is great.

I have been back to work and today our van died at an intersection and I was able to push it down another road. No leaking, no shadowing of blood on the bandage, nothing. The nurse just changed it and was surprised with how active I have been and how the leakage is very low now.

So all in all I am still doing great and still heading to the finish line with no problems.

I hope you both are doing well and are getting closer to finding a fix that works for you both. Take care!
 
#6
Here is the update 27 days since the surgery.

Everything is going very well, I am more mobile. I am able to do more things at work, from kneeling, squats, lying down, contorting my body (turns out people never like to move things in areas where I have to work.). I can sit properly all the time, I can do it for extended times as well although I don't do that anymore considering sitting was one of the reasons I got into this mess in the first place.

The wound looks great, its very shallow, less then 1 cm from the bottom to the top of the wound, 3cm if you count the depth of the wound open to the top of the butt cheek which only 1 nurse actually accounted for, all the rest were using the wound opening. Width and Length are healing normally, albeit slowly to a degree due to the packing but that should be over soon.

I did have a rough weekend due to the health care system. My file clearly states "Do not cancel" in bold large letters on their files yet the home care coordinator called me up and canceled my appointment. She said "Go to the wound care clinic (which is 45 min away from me) or go to the ER." I told her "I refuse to wait for hours to have something done that takes 15 min, if anything happens its on your shoulders. " I was pretty upset. I got my wife to just change the bandage with what looked like a giant band aid. Everything was fine, the next morning I was showering and used a clear tape, its large and is supposed to cover the bandage thing is it stuck too much to the bandage and pulled the entire thing off. My wife had to do everything but she didn't irrigate it correctly as she was never shown. I thought it was fine as the nurse would be at my place between 12 and 1:30. No dice, got a call at 5 stating she was coming, turns out they placed me on evenings without telling me. I even called ahead at about 3 to find out what was going on, waited on hold for 45 min only to be told "Sorry keep waiting, we cannot tell you who has your file or any info."

The nurse that called was very, very upset about all of this. I told her don't bother coming, my wife fixed the issue. She came Monday to check up, she called me 3 hours before she was supposed to be there to touch base and we ranted about the poor coordination together. The only issue she found was a very light green tint, I cannot remember the name she gave it but said it was common. Just monitor it and go from there. She thinks it was from poor irrigation from the day before so she isn't worried as the wound was very clean, smells fine, is healing insanely well, etc. etc.

All in all, wound is great, home care was a piss off on the weekend, I am healing very well. I think I will be able to be on my own next week and I am going to start working out again and I plan on going back to Karate as soon as possible. They nurse thinks they won't have to see me for very much longer.
 
#7
Figured I would update again, its been 35 days since the surgery.

The nurse visits have been less and less because they never call me to touch base and eventually come way too late when they do. If its after 5:30 I cancel and my wife packs the wound and changes the bandage. It's gotten to the point where she basically does it all and is getting very quick with it. I am thinking about dropping the nurses down to 1 visit a week on Sundays. Ever since I went back to work full days they have been slipping constantly. I am starting to run low on supplies so I need them to come tonight so they can order what I need.

I was supposed to see my surgeon yesterday, but my damn power steering hose broke and I had to get it fixed. I moved the appointment to next week.

As for the wound, we haven't measured in a long time but my wife says its very shallow now and doesn't think I need packing for much longer if at all. I am supposed to have a nurse come tonight so I am going to get her to measure everything so I can report back here. My wife said I have a few centimeters of new skin tissue and the wound is much, much smaller in size all around. I can now sit for extended periods in all types of chairs. I can bend down, kneel down, lie on my back, work out, basically do almost everything I did prior to the surgery. I still have no pain, no infection (The green color went away without antibiotics.), the wound doesn't leak nearly as much, I don't need as many bandages either.

35 days in and I can see the light at the end of the tunnel and its coming quickly. Reading all the stories from people makes me feel like my surgeon is good at his job (I found out he does a ton of these in a year.) and that the open excision was a good fit for me. I still can't go back to Karate but everyone is telling me end of the month, early Feburary as that's when they expect me to have proper scar tissue. My work restrictions are cleared Feb 12 and at this point my only problems are when they take the tape off to replace the bandage so I think I am doing pretty good. The only thing I don't like is how long after my surgery it is taking to see my surgeon, he wants to shave the area and make sure everything is good to go and now I have to wait till the 24th. :/
 
#8
Update.

I am officially done with packing because the wound is now very shallow. All they do is use some Nu-Derm strip its basically a few cm long and a few cm wide then slap a bandage on it. The bandage size is a lot smaller now and it turns out all my main issues were because of the damn size of the bandages they were doing before. Now I can kick to waist height, I still will take ti easy but still, I can do almost everything just like normal now.

I see my surgeon tomorrow, I am hoping he is going to measure so I can have a good idea of how big. My wife keeps saying "It's so much smaller.". The light at the end of the tunnel is getting close and closer.
 
#9
48 days since surgery.

My surgeon basically wasted my time. I went in, told him my wife does the bandage change. He told me he didn't have to see it and told me to come back in 3 to 4 weeks. -_- I paid for parking and took time off work for nothing. lol He basically asked if I was feeling ok and that was it.

Anyways, the wound is very small now. No one has measured but my wife says its basically the size of a dollar. I had to take time off work today, I was in the washroom and I guess I ruptured something because it started to bleed a lot which worried me. My wife removed the bandage and cleaned me all up and she thinks there was some fresh tissue that I split as it still seemed to look good. I am sitting with an abdominal pad which is super absorbent and all I can say to people is, don't push too much when in the bathroom.

Still no pain, even with all the bleeding. Normally I don't have any leakage at this point. Cleaning the wound and changing the bandage is super quick. Sweating from working out no longer causes excess leaking. I can do everything normally like I was before the operation. Now I just play the waiting game and hope it scars over fast, once I have the scar I was told to stay light for at least 2 weeks.

I will say, sometimes I feel very annoyed with this entire thing and I really worry about people who have to deal with this for a lot longer then I have. I empathize with you and really hope things turn around for people who are simply having a very slow recovery process. The bandage change every single day can be demoralizing thats for sure.

As usual, if anyone has any questions or needs to do some venting by all means do it and I will try to respond in a timely manner. It's nice knowing there are others out there who understand this strange problem and that we can all sympathize with one another.
 
#10
48 days since surgery.

My surgeon basically wasted my time. I went in, told him my wife does the bandage change. He told me he didn't have to see it and told me to come back in 3 to 4 weeks. -_- I paid for parking and took time off work for nothing. lol He basically asked if I was feeling ok and that was it.

Anyways, the wound is very small now. No one has measured but my wife says its basically the size of a dollar. I had to take time off work today, I was in the washroom and I guess I ruptured something because it started to bleed a lot which worried me. My wife removed the bandage and cleaned me all up and she thinks there was some fresh tissue that I split as it still seemed to look good. I am sitting with an abdominal pad which is super absorbent and all I can say to people is, don't push too much when in the bathroom.

Still no pain, even with all the bleeding. Normally I don't have any leakage at this point. Cleaning the wound and changing the bandage is super quick. Sweating from working out no longer causes excess leaking. I can do everything normally like I was before the operation. Now I just play the waiting game and hope it scars over fast, once I have the scar I was told to stay light for at least 2 weeks.

I will say, sometimes I feel very annoyed with this entire thing and I really worry about people who have to deal with this for a lot longer then I have. I empathize with you and really hope things turn around for people who are simply having a very slow recovery process. The bandage change every single day can be demoralizing thats for sure.

As usual, if anyone has any questions or needs to do some venting by all means do it and I will try to respond in a timely manner. It's nice knowing there are others out there who understand this strange problem and that we can all sympathize with one another.
Hi Canuck84,

I've read all your posts and I can only empathize with you as well. I had really bad sinus 3 or 4 years ago that would repeat itself every month, like an abscess and would need to take antibiotics because A&E would refuse to lance it every time I would go there. Now 3 years later I got it back, this time I had one course of antibiotics and managed to get it drained almost every two weeks since September. I think it's time to so something about ti but I don't really want to take 2 months of work! I can't afford it! How was work with you taking so much time off? I am really worried, at the same time don't want to do open surgery just because of how long recovery time is and because of the packing. Any advice appreciated. Did you go under NHS btw? Did you doctor suggest cleft lift?
 
#11
Hi Canuck84,

I've read all your posts and I can only empathize with you as well. I had really bad sinus 3 or 4 years ago that would repeat itself every month, like an abscess and would need to take antibiotics because A&E would refuse to lance it every time I would go there. Now 3 years later I got it back, this time I had one course of antibiotics and managed to get it drained almost every two weeks since September. I think it's time to so something about ti but I don't really want to take 2 months of work! I can't afford it! How was work with you taking so much time off? I am really worried, at the same time don't want to do open surgery just because of how long recovery time is and because of the packing. Any advice appreciated. Did you go under NHS btw? Did you doctor suggest cleft lift?
My work was fine with it, I work for a phone company as a technician and when I told them I need to have the surgery they were fine with it. I had to use a lot of my sick time to do it mind you. I went back to work 20 days after my surgery. Mind you one of the weeks I took off was booked as vacation. The first week I was doing half days while training someone, the following week I stayed full days while training someone and after that I have been on my own doing almost full duties. Basically only ground based things, no climbing poles or anything.

I'm not sure what NHS is but if its what I think it is then no, I am from Canada so our health care system provided everything, the only things I had to pay for were parking. Everything else was covered.

My doctor didn't mention anything other then open excision, apparently that's all most Doctors will do in Canada.

All I do know is the surgery was very invasive for me because I had 4 of them and they went deep. If I would have done something about it years ago it wouldn't have been so bad. I also lucked out because I had no pain post surgery and was able to sleep, sit and do most things fine. At that point it was the tape holding the bandage that was actually hurting me and making me feel very uncomfortable. Thing is everyone deals with this differently, I have heard some people are in a lot of pain.

I'm also not going to lie, the packing for almost 2 months was starting to wear me down, it was very annoying and demoralizing but I am past that stage. Now it's just a small surface wound that is closing seemingly every single day. I don't regret my decision, I just wish I would have known how extensive it was because I would have waited another year or 2 and banked more sick time.
 
#12
Update, a little over 2 months.

I saw my surgeon finally and he actually looked at the wound this time. He saw some granulation and used some silver nitrate to cauterize and help promote faster healing and he thinks that is what was causing my random bleeding from time to time. He said the wound looked great, nice and pink all new tissue. He wants me to go back to packing the wound, he said it's superficial but he just doesn't want it to close too fast. He said my wife is doing a great job at playing nurse and said she has been doing better then some actual nurses! lol He wants to see me in another 4 weeks to reassess and see where I am at. He thinks that I will probably have the wound fully closed by then and will just be dealing with fragile skin for a little bit.

All in all, he is impressed with how I am healing. I still have no pain at all either so as far as open excision healing goes I am doing great.
 
#13
Any updates on your healing? I had the surgery back in Sept and healed about the same pace. I was always afraid to sleep on my back which caused a lot of back pain on top of everythingelse. It sounds like your wife has taken great care of your wound and that youre doing well considering some of your earlier issues. My surgeon made me pack it till it wouldn't pack anymore. And those Band-Aids; my God. My skin was raw from peeling and reapplying.

Hope you're seeing some light!
 
#14
Any updates on your healing? I had the surgery back in Sept and healed about the same pace. I was always afraid to sleep on my back which caused a lot of back pain on top of everythingelse. It sounds like your wife has taken great care of your wound and that youre doing well considering some of your earlier issues. My surgeon made me pack it till it wouldn't pack anymore. And those Band-Aids; my God. My skin was raw from peeling and reapplying.

Hope you're seeing some light!
The wound is almost finished healing. I get a bit of blood on the dressing but not much at all, I don't leak out anymore either. Its very small so I would imagine this will take a bit to heal but its almost all fresh skin now. I am at the point where I can do everything I did before the surgery including lower body stretching and I can kick properly again although I still take it easy as I don't want to screw anything up. lol

Yeah my wife has helped a lot, she changes the dressing every single day still which is great.

I hear you on the tape, my butt was raw for awhile because of the damn stuff. They gave me a new type of tape, its stretchy and doesn't hurt nearly as much as the old stuff when taking it off.

The only problem I have is a sore spot which also gets stiff on my back. Its where they put the spinal anesthetic. I was told that would go away within 3 or so weeks but I still have pain and stiffness there. Thats so minor in the grand scheme of things though so I am okay with it.
 
#15
Update, day 76, just over two months.

So far so good. After I was given the silver nitrate the wound started healing a lot faster and I haven't bled since at all. I am not really leaking and the bandage only has leakage after I work out so its basically sweat. I am still changing bandages everyday but at this point its just because I am paranoid and don't want to screw this up.

The wound is insanely small, my wife says maybe the size of a pinky finger nail, if that. I am back to doing everything normal, so I am now able to climb telephone poles and do everything in martial arts, even ground work. I still wear an abdominal pad when I do Karate with some compression underwear that the doctor gave me so I can hold everything in place. Even after an hour and a half class I barely have anything on the bandages. I can sit for extended periods, drive for however long, sleep on my back, etc, etc.

All I can say is I cannot believe that I waited this long to get it done. I've had it for 6 or 7 years and I have to say I feel a lot better. I guess my body constantly fighting an infection was doing something to me because I have way more energy now then I did before. I just feel very relieved that they are removed and I am at the end of the healing process.

The doctor says everything is looking great, I am healing very nicely and he said I have a very, very low chance of re-occurrence because of how big the wound was and how much they took out combined with how good of a job my wife and I have been doing with caring for it. He doesn't expect me to ever deal with it again but he won't say for %100 which makes sense.
 
#16
Hey guys. So I did the open wound surgery on November 2nd of 2017 and the wound has been taking a while to heal. its now end of feb and im still packing it. Ill show a pic of before and after and where im at. Quick question though, is there any type of gel or anything that can speed the process of healing? Its just sometimes the wound closes and theres no blood, and sometimes theres a whole there still. All my nurse uses is the sterile water and packs it. But again, im very athletic and I need this to heal soon cus im losing my damn mind. Any ideas that anyone can share with me? Thanksss
 
#17
Hey guys. So I did the open wound surgery on November 2nd of 2017 and the wound has been taking a while to heal. its now end of feb and im still packing it. Ill show a pic of before and after and where im at. Quick question though, is there any type of gel or anything that can speed the process of healing? Its just sometimes the wound closes and theres no blood, and sometimes theres a whole there still. All my nurse uses is the sterile water and packs it. But again, im very athletic and I need this to heal soon cus im losing my damn mind. Any ideas that anyone can share with me? Thanksss
How deep was your wound to begin with and how deep is it now?

I am not doing anymore packing just a strip of something called New Derm alginate which is seaweed then the bandages on top. We use the sterile water to clean it and thats about it.

For awhile when I was packing they would put in some sort of gel so things didn't stick to the wound but even then without it I never had anything stick.

I babied the hell out of it for awhile though, I didn't start working out again until like the 2nd month and even then it was modified, no sitting, no movements that put pressure on it and nothing that could potentially rip it.

As far as speed, my surgeon saw some granulation and used silver nitrate to get rid of that and speed up healing and it seems to have worked. I no longer bleed unless someone actually pushes too hard on it.
 
#18
Update, Day 93

I just saw my surgeon today. The wound is closed but I have fresh fragile skin a few millimeters wide and maybe 4 cm long. They said I shouldn't have to worry about tearing it as they stretched the area and it didn't leak, bleed, tear or anything.

I finally don't have to wear a bandage anymore (I hated the tape so damn much!) and I can now shower normally. Still no pain, the leaking is all gone as it's been about 6 days now where the bandage has had no leaking on it what so ever!

It feels weird now not having to sit with a bandage, almost feels like I am missing a part of my body as I had to wear one for so long. lol

I have one final follow up May 15 and they think I will be fully healed completely before then. It's been a long time but I have to say the relief from this problem feels so damn good.
 
#19
Turns out I jumped the gun. I had a lot of bleeding this morning when I sat to use the washroom. My wife cleaned it all up and the bleeding has stopped. I actually felt the area for the first time since before the surgery and it kind of shocked me. I have a little divot it feels like and I am pretty sure that's where I bled from. The area is pretty damn hard at this point. I haven't had the bleeding for awhile and thought this was the end but what can you do. I do feel a bit off today but I am at work so things are not that bad.

It's weird, I went hard this past Thursday and Saturday with Karate and had no leaking at all yet I sit and I bleed a ton. Weird healing process I guess.
 
#20
Hopefully this works for you and it stays closed!!

You mentioned waiting which i doubt would have been a good idea as it may have grown and become worse or possibly an abscess would have formed which can be painful.
 
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