Preparing for pilonidal surgery: it’s pretty easy

Antibiotics

We start all patients on antibiotics the day of surgery, and continue them for a total of a week. We usually use a combination of ciprofloxin, and metronidazole (Cipro and Flagyl). We recommend taking a quality probiotic starting before the surgery and continuing for a few months after you finish the antibiotics. We recommend Ther-Biotic Complete, from Klair Labs, one capsule daily, as an excellent choice.

Diet

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. Please look at our “Nutrition for Healing” 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.

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. It is a good idea to start a stool softener a few days before surgery, and continue it for a few days afterwards.

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. Covid19 testing may be required, and this page will have the current requirements.

Anesthesia

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

Travel

If a cleft-lift is performed, a drain is placed which needs to remain in place a minimum of 4 days. We have had patients stay in Eau Claire for a wound check and drain removal at 4 days; or go home and come back in 5-7 days; or have a surgeon, nurse, or wound-care specialist back home check the incision and remove the drain. We are happy to work with other physicians to make your recovery as easy as possible. However, in more severe cases where patients have had previous failed surgery, wounds near the anus, or complex cases for various reasons, Dr. Immerman may want you to stay about a week for a post op check, and possible drain removal. We will let you know how long we would like you to stay when your surgery is scheduled.

We have had many patients drive several hours to get home the same day as the surgery and that seems to go well, but can make for a long tiring day for everyone involved. The next day might be better. Sitting is not restricted after the surgery, but if the vehicle is roomy enough to allow changes in position, that is optimal.

We do not recommend getting on a plane the day of surgery. We’ve had several patients fly home the next day – but we feel that is pushing it a bit. Our recommendation is that you give yourself a couple of days to recover before attempting to go on a flight.

What to bring

This page list some of the things that you don’t want to forget.