What is the follow-up care for patients with pilonidal cyst and sinus?

Updated: May 20, 2019
  • Author: Alex Koyfman, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Answer

First, packing removal needs to be performed. Generally, a formal wound check should be offered to the patient in the ED or office in 1-2 days, with removal of the packing at that time and redressing of the wound. However, if the patient is reliable and unwilling to return to the ED, he or she can remove the packing at home as long as care is taken to ensure that the ribbon is completely intact when removed. Once packing is removed, site cleansing with warm shower water or sitz baths should begin right away and be taken 2-3 times per day. A clean dressing should be applied after cleansing and continued until the abscess cavity has closed primarily.

Surgical follow-up is recommended in about 1-2 weeks. This allows the surgeon to examine the wound for healing, assess for potential recurrence, ensure that no other diagnosis and therapy should be considered, as well as arrange for definitive care of the sacrococcygeal region if necessary. [8, 4]  At least some literature suggests that conservative therapy with good local hygiene and site shaving every 1-3 weeks have been shown to be as effective in preventing recurrence as a secondary surgical procedure. [1]


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