What is pilonidal cyst removal?

Pilonidal (say "py-luh-NY-dul") cyst removal is a type of surgery. It removes a pilonidal cyst at the top of the crease of your child's buttocks.

The doctor may use medicines or special tools and small cuts. In some cases, a larger cut is needed. When more tissue is removed, a skin flap may be needed. Some cuts may be closed with stitches. Your child will likely have one or more scars that will fade over time.

Your child will probably go home several hours after surgery. It may take anywhere from a few days to a couple of weeks before your child can do most of their normal activities.

But until the area has fully healed, it's important that your child not sit for a long time or do any type of hard or challenging exercise.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Shower as usual. Pat the area around your incision dry with a towel when you are done. Avoid baths until the wound is completely healed. Keep the area dry and clean.
• Ask your doctor when you can drive again.
• Avoid sitting for a long time or sitting on hard surfaces while you are healing.
• Most people are able to return to work anywhere from a few days to a couple of weeks. It will depend on the type of surgery they had.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Incision care

• If your incision was closed with stitches:
  • Wash the area daily with warm water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing.
  • You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.
• If your incision was left open to heal, change the bandage, called a dressing, as instructed by your doctor.
  • Dressing changes may hurt at first. Taking pain medicine about half an hour before you change the dressing can help.
  • If your dressing sticks to your wound, try soaking the dressing in warm water for about 10 minutes before you remove it. You can do this in the shower or by placing a wet washcloth over the dressing.
  • You may notice greenish gray fluid from your wound as you start to heal. This is normal. It is a sign that your wound is healing.

Other instructions

• Use a coccyx cushion if sitting is uncomfortable. This type of cushion keeps pressure off your tailbone (coccyx) while sitting.
• In some cases, keeping the area free of hair may prevent problems. Ask your doctor if you should remove hair from the area and what method of hair removal they suggest.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that having the cyst removed will help your child feel better.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

• You may get a call from your doctor's office to confirm the time and date of your child's surgery.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

You had surgery to remove a pilonidal cyst. How long it will take for you to heal depends on the way your surgery was done. After healing, you will have a scar or scars from the procedure. These will fade and become softer with time.

Most people can go back to work and most activities anywhere from a few days to a couple of weeks. Your doctor will let you know what to expect. Until you have completely healed, you will need to avoid strenuous exercise and activities that require long periods of sitting.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take their medicines on the day of surgery, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush their teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that reminds them of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by the anesthesia provider. The anesthesia may make your child sleep. Or it may just numb the area being worked on.
• The surgery will usually take about an hour.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor your child's condition. The doctor will talk to you about the surgery.
• Most children are able to go home a few hours after the surgery.