Pilonidal Sinus - Wide Excision - Healing by Secondary Intention - Post Op Diary!

Peter Moulding

New Member
Hi guys, like most of you here I'm writing my experience down so that someone might see it and take away some info or feel better about something - because I know how difficult it can be living with Pilonidal Sinus.

Pre op: So, I noticed I had PS about four years ago. At first, it was blood on sheets. After a few months, it was a small bump. I left it for about a year before seeing a doctor because I had no pain and thought it would go away. The doctor said it was a cyst, so I went to see a dermatological surgeon (UK) about getting it removed. He then told me it was PS and that if I kept it clean then living with it would be way better than living with surgery. Fair enough, saves me from going through the hassle of my first operation. So, I then carried on with life for about three years (and moved to Germany) under the impression everything would be fine. But, it got worse... a lot worse. It got much bigger and I could feel the tunnels spreading upwards. When I finally went to see the doctor a second time, the pain came and went, it had flared up twice and it was painful to sit down for longer than 10-15 minutes. The German doctor took one look at it and said it has to go and they asked which surgery I would like: the flap or wide excision. I said I wanted the flap because the open wound sounded horrible. Two months later and I had just woken up from the operation and, unfortunately, my PS was too big and so they had to use the wide excision method.

What to expect post op - week 1: This was as painful, bloody and difficult as what I had read about.
I spent the first 3 days in hospital. The wound was about 8cm long and 2cm deep, but not sure exactly how wide. Those 3 days were painful and bloody. I had blood on my sheets and on my gown. I could barely walk or move. Sleeping was sometimes hard. And, going to the toilet was also difficult. I was asked to lay on the wound, as it would help stop the bleeding. The nurses changed the bandage once a day and I was given painkillers whenever I needed them. These few days were pretty difficult, to say the least. I was sent home on day three. The wound continued to bleed all week. I had nurses come to my house to change the bandage, they told me not to put pressure on the wound anymore. It was still often very painful at this point. I spent my time watching films and reading books to keep my mind off the pain. I went on my first walk on day five. The hardest part was getting up and down the three flights of stairs to my flat. I managed to walk about 100 meters before it was too much. The worst part was the blood which leaked through my clothes.

What to expect post op - week 2:
After the bleeding stopped, everything quickly got back to normal.
At this point I was praying for the bleeding to stop. For me, it was all about seeing some progress. Every day in week 2 I walked and worked from home (luckily I can do that, mainly because it kept me from going insane). My walking goals were to get to the end of the street, then to go around the block, and then to the shop etc etc. It was on day 10 that the bleeding stopped and I was very happy about it. After the bleeding had stopped, the pain also seemed to go away. Sleeping, walking and moving were all much easier. During days 12, 13 and 14 I used no painkillers at all and I could barely feel the wound apart from the fact I had a big nappy on. It was during those days that I began to try sitting again, which was hard at first but got better. Every day since my op, the nurses told me the wound looks good and very clean. Now, also, that the blood had gone, they could see how deep it was. And yes, it was bone deep.

What to expect post op - week 3: Alles gut!
I'm now on the fourth day of my third week, so 18 days after my op. Every day since I could walk properly again I have continued to increase my walking distance. On Monday of this week I walked about 2km, Tuesday 3km, Wednesday 6km. All walks with barely any pain. I can now sit on the wound quite easily. There is no blood or liquid coming from the wound. The only problem I still have is that I cannot reach my feet, so I have to ask my girlfriend to tie my shoes...The nurses also say that the wound is now getting thinner every day and I should have only one month, or less, until it is completely healed.

Conclusion so far: Although the doctor said that I should get the PS removed, it was still my choice. And, it was a very good decision. I had heard many bad stories about PS surgery, and my experience, thankfully, hasn't been so bad. I would not have thought that I would be almost completely back to normal 18 days after my op. I say almost because I still have a nurse come every day, I still cannot lie on the wound and I still cannot tie my own shoe laces. Also, tomorrow I'm allowed to have my first proper shower since the op!

- Eat healthily and drink plenty of water every day after your op. The doctors told me to do this and I have tried my best. I try to eat plenty of fruit and veg etc. Although we have no concrete evidence, I'm guessing this has helped with my recovery. Also, eat lots of bread as it helps with going to the toilet.
- Make walking goals. Being a very outdoorsy person, this helped me a lot. And, walking helps with recovery.
- Get lots of rest, if you can. Luckily, I can work from home so I have managed to get as much rest as I can.
- Buy plenty of baby wipes to help with toilet stuff, it's just easier.
- Get used to stand up washes as well. I can't wait to have my first shower tomorrow.
- Don't get someone to take a picture of your wound. At least, this has helped for me. It's this whole thing about feeling pain if you see it. I have no idea what my wound looks like, and I only want to see it when it has healed. I don't know how big or scary it is, and so I'm not getting too overwhelmed with it.
- Don't get too freaked out about open wound surgery. It sounds bad and the first week is pretty horrible, but it gets better.

If the nurses are right, then I should be completely healed in 3-4 weeks. But, I'll keep you updated on the progress!