Care can last 4 to 12 weeks depending on the extent of the wound. The wound packing dressings are provided as nursing care, and the quality of the nursing care is very important throughout the healing period.
Indeed, care must be taken to ensure that healing takes place from the base and to prevent the edges of the wound from closing before the base, hence the importance of regular checks by the nurses and of repositioning the packing and gauze to prevent the wound from closing too quickly. Showers can be taken very soon, with or without the dressing, depending on the time of the nursing care. It is best to arrange with your nurse to schedule the dressing just before or after the shower.
The surgery consists of the excision of the main opening and the secondary openings, as well as the subcutaneous tunnel or tract that connects them.
After the excision, a hole in the flesh, or cavity, remains
The cavity can be filled by an intra-operative skin plasty, which is often partial because it is limited. The rest of the cavity must be left to heal by secondary intention with packing that a nurse will change every day. The aim of this manoeuvre is to allow healing from the base towards the surface; otherwise the edges could close at the surface and create a dead space, a source of recurrence and infections.
At the end of healing, the surgeon needs to check that there is no excessive granulation (or hyper-healing) preventing the skin from covering the wound.
Dr Grégoire Deroide
See also: Pilonidal sinus: surgical treatment
