Wound is not healing, need advice please

#1
Hi,
I am a 21 year old from Adelaide South Australia and had surgery for my pilonidal sinus last year (December 13th, 2018). My stitches popped open 2 weeks post surgery, and I have been getting the wound cleaned and packed daily since then. It has been an extremely long and frustrating 8 months, the wound seems to progress and get smaller and then it takes 2 steps back and gets deeper again. I am extremely careful with it, I avoid sitting for too long and don't exercise - which has been very difficult for me as I have always been an active person and used to go to the gym daily. It has been a very disheartening experience and is taking a toll on my mental health due to how restricting it has been. My surgeon, the nurses and doctors I have seen can't understand why it's not healing as I am young and healthy (with a good diet). I have also tried multidex and a few other gels that supposedly speed up the healing process, but nothing has worked.

I am unsure if should play the waiting game and hope it heals, or have another surgery. If I go for the surgery option I'm unsure which procedure to try next, possibly a z plasty or cleft lift? I definitely don't want to have two failed surgeries and would love to ensure I'm having the most promising procedure along with a good surgeon. If anyone from Adelaide has had a positive experience with their surgeon any suggestions would be greatly appreciated because I have no idea who to see.

I am so desperate to have this problem fixed once and for all as I graduate from uni in November and would love to move interstate next year to start work, but having this wound will put everything on hold as my mum is a nurse and she is dressing it every day. Any advice would help me a lot as I'm feeling really unsure, thanks all.
 
#2
Your story and situation is very similar to mine and I know first hand what it is like to not be able to exercise and play sport. I have had 6 surgeries (and counting) on this stupid problem in total to remove sinus tracts and to get the resulting wound to heal. From my experience, the skin flap procedure (I think this is similar to the z-plasty and cleft lift ?) is the way to go as it involves cutting a section of skin from the side of the wound across and stitching it into place. This ensures that the wound has some tissue from the flap to connect and grow in to as well as narrowing the depth of the overall natal cleft where the problem occurred, which significantly decreases the chance of it reoccurring again in the future. Unfortunately for myself, the sinus reoccurred in a new section further down so I am probably going to end up having the same procedure done again, since my history with getting closed wounds to heal is not good.

Anyway, I hope you find some part of this helpful and I know exactly what it is like to del with !
 
#3
Hi!

I have just healed from my second surgery. The first was with stitches and I also struggled a lot. The wound didn't heal fully and I ended up getting another pit after 7 months. The second surgery was an open wound surgery sealed with a vacuum seal. Please see my profile for the experience I had. I wrote a thread on it.

The vac seal ensures the wound closes and even though I'm only 3 months post op, the wound is completely healed and I'm able to exercise for the first time in a year! I would highly recommend you ask your surgeon if it's possible to do the same for you. Good luck and keep us posted!
 
#4
@samtk
Hi!

I have just healed from my second surgery. The first was with stitches and I also struggled a lot. The wound didn't heal fully and I ended up getting another pit after 7 months. The second surgery was an open wound surgery sealed with a vacuum seal. Please see my profile for the experience I had. I wrote a thread on it.

The vac seal ensures the wound closes and even though I'm only 3 months post op, the wound is completely healed and I'm able to exercise for the first time in a year! I would highly recommend you ask your surgeon if it's possible to do the same for you. Good luck and keep us posted!
Thanks for replying and for sharing how your experience went, the vacuum seal sounds like a great way to go and was one of my next options. My open wound has actually FINALLY healed at the start of November last year! I have just begun exercising again and getting back into a normal routine. I know how common it is for the sinuses to come back but at least now I know how to go about my surgery if there is a next time, I think the vacuum seal sounds like a good way to go.
 
#5
Hi!

I have just healed from my second surgery. The first was with stitches and I also struggled a lot. The wound didn't heal fully and I ended up getting another pit after 7 months. The second surgery was an open wound surgery sealed with a vacuum seal. Please see my profile for the experience I had. I wrote a thread on it.

The vac seal ensures the wound closes and even though I'm only 3 months post op, the wound is completely healed and I'm able to exercise for the first time in a year! I would highly recommend you ask your surgeon if it's possible to do the same for you. Good luck and keep us posted!
Your story and situation is very similar to mine and I know first hand what it is like to not be able to exercise and play sport. I have had 6 surgeries (and counting) on this stupid problem in total to remove sinus tracts and to get the resulting wound to heal. From my experience, the skin flap procedure (I think this is similar to the z-plasty and cleft lift ?) is the way to go as it involves cutting a section of skin from the side of the wound across and stitching it into place. This ensures that the wound has some tissue from the flap to connect and grow in to as well as narrowing the depth of the overall natal cleft where the problem occurred, which significantly decreases the chance of it reoccurring again in the future. Unfortunately for myself, the sinus reoccurred in a new section further down so I am probably going to end up having the same procedure done again, since my history with getting closed wounds to heal is not good.

Anyway, I hope you find some part of this helpful and I know exactly what it is like to del with !
Thanks for your response, I hope you're having more luck with your surgeries now and the problem is gone once and for all. I was looking into doing a skin flap procedure if I were to get another surgery, I just couldn't find many surgeons to perform it for me in Adelaide. But my wound has finally healed now thankfully and I am back to normal and exercising after over a year of not being able to do anything. Thanks heaps for your advice and all the best!!
 
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