Open Excision Failed - Going to see Dr. Immerman in two weeks!

Hey everyone,

Given how miserable the first procedure / existing process was, I thought I would post up a bit of my experience that may help others in the future.

First Procedure - Open Excision w/ Secondary Intention Healing:
I had pain in the pilonidal area for a couple of years on and off, but never experienced any drainage. Just occasional swelling and pain, and it would subside and return. After seeing my PCP, they referred me to a general surgeon for a consultation, and I went to see him the same day. He took a very brief look at the area (with me standing) and immediately said that it was a pilonidal cyst that would need to be excised. He scheduled me for surgery and off we went.

My surgery was 11/15/18 and was complete within about an hour or so. I went home that same day and noticed some pretty extensive bright red blood drainage through the dressings applied during surgery, and almost immediately needed to replace them (regular cotton gauze). This seemed unusual, so I called the surgeon to see if he could check it out to make sure nothing went 'wrong'. I went to see him, he mentioned that something got missed during the cauterization, re-packed my wound and sent me on my way. After this, there was regular drainage as expected, I got set up with a wound care clinic twice weekly and started my looong journey of trying to heal this thing.

As prescribed, I used Aquacel AG for packing / dressing and covered the area with some higher end Optifoam LQ pads every other day. Pretty quickly the large original wound started filling in and I thought all was well and continued to stay the course.

When the problems started (4-5 Month Mark):
Flash forward to 5 months later, the fact that my wound hadn't completely healed started to get disconcerting to not only me, but my wound care clinicians as well. There appeared to be no obvious issue (infection etc...) but for whatever reason, the wound would close and almost immediately open somewhere else. This got to be quite frustrating, so I was referred back to my original surgeon to take a look. He saw it and concluded that everything was fine, that there was some hypergranulation, and hit me with some Silver Nitrate.

After this, there was an almost regular back and fourth from the wound care clinic to the surgeon. It would stall, he would use silver nitrate, it would resume. It would close, it would reopen. Naturally, this has taken a pretty big toll on me mentally, but I stayed the course.

6 Months and Still Open:
Things started to look up! It was healing and the scar was appearing to look rather strong. I went to visit my wound care clinic last Thursday out of habit, and she said that it appeared to finally be healed! I left the office, went back to work and suddenly noticed pain, and a pretty significant amount of blood in and around the dressing. This felt like a huge gut punch... I was so close!

I went home and changed the dressings to examine the wound. It went from zero to what appeared to be a 1.5cm tall, .5cm wide and .9cm deep wound that just opened! I knew immediately that this was very unusual.. and just tried to keep my wits about me as I couldnt have it looked at professionally for a few days.

I visited wound care today and they mentioned that there had to be some pre-existing tunneling that just never healed from the inside out. As I am super fed up at this point, I knew it was time to contact the BEST to fix my issue. And based on what I've seen here, one of them seems to be Dr. Immerman.

Dr. Immerman and Cleft Lift:
I spoke with his team today, sent them pictures etc... and got on the schedule to have my procedure done on 5/29. I live in Georgia, so I will be flying in with my brother, and I plan to stay one full week for the follow up.

After dealing with this healing process for so long, I'm nervous to have another procedure. But it seems that this is the best choice!

Does anyone have any immediate advice for before / after this procedure? Immerman seems extremely knowledgeable, and has great resources... but some words of encouragement would help.

Dr. Immerman will heal you! He is the absolute best doctor I have ever been to. Listen to everything he says and you will be good. Good luck to you!
Thanks Jon, I've read just about everything I can find about him, the procedure etc... I think just dealing with this nonsense over the past 6 months has made me lose a bit of faith!
Thanks Jon, I've read just about everything I can find about him, the procedure etc... I think just dealing with this nonsense over the past 6 months has made me lose a bit of faith!
Totally get it. After 3 failed surgeries and years of misery I totally understand. Dr. Immerman is not your regular doctor. You will be in the best hands possible.