Post Incision and Drainage (I&D first time)


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So I’m about 10 days in after having a pilonidal abscess drained. Surgeon left the wound open with instructions to unpack, clean, and repack with iodoform gauze at least once per day. My father is assisting with the re-packing of the open wound. I had my follow up appointment today 10 days since the I&D was performed.

The gauze packing is becoming difficult for my Dad..he doesn’t seem comfortable forcing the little bit of gauze that may be able to fit in there at this point. He’s broken the wooden q tip twice now trying to stuff it in..maybe he’s just not being gentle enough but I don’t think it should hurt that much or start bleeding from pressure being applied. I tried explaining this to the surgeon during my follow up appointment and she said “if you want you can stop, just continue to clean it and keep it covered with gauze”

She did take a good look at the wound and everything seems to be going according to plan so far I’m just confused why she wouldn’t tell me one way or the other if I should still be trying to pack it with gauze. Anyway if it’s up to me I’m not going to continue having my dad pack it if it’s not necessary. I really wish I would have asked her how deep it was because apparently if it’s 1/4” deep or less it doesn’t need to be packed. I also see plenty of people on this forum saying they had this same procedure where the wound was left open but not packed with gauze.

I’m just curious for anybody that’s been through the gauze packing after I& long did it take before packing was no longer necessary/possible?


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I never had an I&D but have a few thoughts. First what size is the iodoform? They make 1/2 and 1/4 if you're using the larger maybe consider going down in size. When I had mine packed 3X a day it was just putting the packing in to wick out the exudate. No forcing no bleeding except once when I had to have a girl at work do it, she took the word packing liberally, very liberally. There was a bit of blood then.

Again I didn't have the same procedure as you just some thoughts. Then again if your surgeon told you it was ok to discontinue packing then she likely thinks you've healed enough or that it's dry enough to discontinue.

Best of luck!