Preparing for pilonidal surgery: it’s pretty simple.


We start all patients on antibiotics before surgery, and continue them for a total of a week. We usually use a combination of ciprofloxin, and metranidazole (Cipro and Flagyl), or Augmentin alone. If we are sure surgery is planned, we will start them orally the evening before surgery. If not – we start them intravenously right before the procedure. Either way, we continue them orally post op for almost a week.


If you are going to have an operation you must not have had anything to eat after midnight the night before the surgery (or eight hours before the surgery if it is late in the day). You can have clear liquids up until three hours before the surgery. Clear liquids include water, juice, Jell-O, tea, black coffee, etc. If these instructions are not followed, the anesthesiologist may cancel the procedure.

It is also important that you go into surgery well nourished, and that you stay nourished during the post-op healing period. This especially means plenty of protein, and certain particular vitamins. This link will take you to a page that discusses certain vitamins and supplements that will promote pilonidal wound healing. Dr Immerman would like you to start these as long before the operation as possible, and continue them for at least six weeks after the operation.


There are no enemas or laxatives given for the procedure.


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.


Dr Immerman usually performs this procedure with you asleep. A long acting local anesthetic is also injected to help with post operative pain control.