Pilonidal means "nest of hair”. Pilonidal cysts are usually located at the end of your tail bone. It contains skin debris and hair follicles. It can get infected and causes swelling, pain and abscess. The first initial treatment for pilonidal abscess is drainage and control of infection with wound care (frequent washing with soap and water) and antibiotics. When the cyst is settled, it can be left alone with hair elimination from the area and keep the sinus openings clean or proceed with surgery.

Surgical option includes: 
1) Excision and simple closure (high chance of infection)
2) Excision and leaving the wound open for self-closure (high chance of none-healing)

3) Excision and closure with a reconstructive flap technique, such as a "cleft lift" procedure also known as Bascom technique. (best chance of healing and minimal recurrence)

( Bascom, John; Bascom, Thomas (October 2002). "Failed Pilonidal Surgery". Archives of Surgery 137 (10): 1146–50. doi:10.1001/archsurg.137.10.1146. PMID 12361421. )

- As the treatment options can be different for each individual, Dr. Bahasadri will discuss your best options with you.

- After surgery you will be given instructions for wound care and follow up visits.

Post-operative Care following Pilonidal sinus operation

 1. You can expect some pain and swelling in the area of your incision. This is normal and will go away with time. You may notice a firm ridge developing under the incision in the next few weeks. This is called a healing ridge and is a normal part of the healing process.

2. Please remove any gauze dressing the day following the surgery and cover the incision with a panty liner.

3. Change panty liner at least 2-3 times a day. Place panty liner over the wound once the area is dry and hold it in place with your underwear (no tape please, it can damage your skin). Don’t worry if some fluid seeps directly through the incision.

4. A drain was placed at the time of surgery. Empty the bulb twice a day and record the amount.

5. For the first 2 weeks after surgery, please clean yourself after bowel movement with soap and water carefully and with baby wipes when you don’t have access to water.

6. Activity: Take it easy for the next two weeks. Gentle Sitting and walking are encouraged. Avoid sit-ups and activities that place pressure on your incision for several weeks (no bike or motorcycle riding or sports).

7. Do not drive, operate machinery, or make important decisions the day of your surgery.

8. Make an appointment to see Dr. Bahasadri for your first postoperative appointment to have your drain removed.

9. Symptoms to report:

• Temperature over 38.5 degrees Celsius.

• Persistent nausea or vomiting

• Bleeding not controlled by applying steady pressure to the area for 20 minutes

• Extreme pain not relieved by prescribed medication

• Inability to urinate for 8 hours after surgery or passing very small frequent amounts of urine

IF YOU REQUIRE IMMEDIATE MEDICAL ATTENTION AND ARE UNABLE TO CONTACT DR. BAHASADRI, PLEASE GO TO THE EMERGENCY ROOM AT ETOBICOKE GENERAL HOSPITAL OR YOUR NEAREST EMERGENCY ROOM.

  • If you have any questions, please call our offices at 416-913-6457 during our office hours.