Patient Instructions

INSTRUCTIONS FOR BEFORE AND AFTER PILONIDAL SURGERY

Antibiotics:
We start all patients on antibiotics the day of surgery, and continue them for 5-7 days.

Diet:

The morning of your surgery it is imperative that YOU HAVE NOT HAD ANYTHING TO EAT OR DRINK AFTER MIDNIGHT THE NIGHT BEFORE SURGERY. If you do not follow this instruction, we may not be able to do your operation as planned.

Bowels:

There are no enemas or laxatives given for the procedure, but post op constipation can be a problem because of discomfort in that area coupled with the constipating effect of many pain medications. If you experience constipation after surgery, you can purchase magnesium citrate over the counter and drink half of the bottle. If you not have relieve within 3 hours, drink the second half.

Shaving:

We do NOT recommend that you shave the area before surgery. Shaving has been shown to increase wound infection rates. The operating room staff will use surgical clippers to trim the hairs in the area after you are asleep. We do not recommend shaving the area after surgery either.

Laboratory Testing:

There is no specific pre-operative testing needed, as long as you are under 40 and in good health. Of course, if you are on certain medications or have medical problems, appropriate testing will be needed to insure that the anesthetic can be given safely.

Anesthesia:

This procedure will be performed with you asleep (general anesthesia). A long acting local anesthetic is also injected to help with post operative pain control.

Pain control:

We do not prescribe any pain medications following the surgery. You may take a combination of Tylenol and ibuprofen in an alternating manner every 3 hours as needed. For instance, if you start at 9am:

9am: 1 tablet of extra strength Tylenol (500mg) or two standard strength (325mg x2)

12pm: 400mg of ibuprofen (advil/Motrin)

3pm: Tylenol

6pm: the ibuprofen and so on.

Drain:

You will have a surgical drain that we keep in place for about 1 week. On occasion it remains in place longer. Dr. Rafailov prefers to see you in the office a week after your surgery for a postop check and drain removal. If you are unable to visit, the drain can be removed by family or any caregiver by referencing the video that Dr. Rafailov’s office will share with you.

Activity and showering:

You are able to sit normally, lay on your back and climb stairs. You may shower 24 hours after your surgery. If the dressing around your drain gets wet, please replace it. DO NOT SUBMERGE FOR 6 WEEKS (no baths, pools, hot tubs, lakes, oceans…)

NO saddle sports, sit-ups, lunges, horseback riding, cycling, rowing, strenuous exercising with excess

sweating, or contact sports for 6 weeks.

Hygiene and wound care:

You may use a bidet or a handheld shower head to clean after having a bowel movement. You may also use wet wipes and wipe AWAY from the wound. Once clean, pad the area dry. A small amount of discharge may appear for up to 1 month.