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Suggest Post Surgery Care After A Sebaceous Cyst Surgery
Question: Hi..
I underwent a sebaceous cyst surgery on Feb 28th. It was present in the sacral region. The surgery was performed when the cyst was infected by a plastic surgeon. The surgery went well but the serum in the attached drain did not stop coming even after 2 weeks of the surgery. Doctor removed the drain and stitches after 2 weeks. But the next day after surgery a gap developed at the site and significant amount of serum started coming from it. Doctor advised to continue dressing for a week. After a week the wound healed by about 5-10%. Doctor predicted that there might be some wall of the cyst left in the skin. He advised for a re-surgery. I consulted another surgeon and he told me that a pilonidal sinus is developed below the operated zone and a track is developed between the zone and wound(gapping). He also advised for the surgery and told that the wound will not heal because of the sinus and serum dischargw..
I dont understand why the views of the two doctors vary and what should I do now?..should I go for a re surgery? If yes, then whom should I get operated by...the old plastic surgeon or the new general surgeon.. It has been almost a month and there are no signs of improvement...
I underwent a sebaceous cyst surgery on Feb 28th. It was present in the sacral region. The surgery was performed when the cyst was infected by a plastic surgeon. The surgery went well but the serum in the attached drain did not stop coming even after 2 weeks of the surgery. Doctor removed the drain and stitches after 2 weeks. But the next day after surgery a gap developed at the site and significant amount of serum started coming from it. Doctor advised to continue dressing for a week. After a week the wound healed by about 5-10%. Doctor predicted that there might be some wall of the cyst left in the skin. He advised for a re-surgery. I consulted another surgeon and he told me that a pilonidal sinus is developed below the operated zone and a track is developed between the zone and wound(gapping). He also advised for the surgery and told that the wound will not heal because of the sinus and serum dischargw..
I dont understand why the views of the two doctors vary and what should I do now?..should I go for a re surgery? If yes, then whom should I get operated by...the old plastic surgeon or the new general surgeon.. It has been almost a month and there are no signs of improvement...
Brief Answer:
Packing and field dressing for 2-3 weeks.
Detailed Answer:
I have taken note of your query and I have understood it.
I think you can wait for another 2-3 weeks before going in for a re-surgery.
I would advice packing the wound with betadine dipped sterile gauze and the covering it with a field dressing so as to allow the wound to heal by secondary intention.
An antibiotic may be started if there is pus discharge or pain at the site.
Regards
Packing and field dressing for 2-3 weeks.
Detailed Answer:
I have taken note of your query and I have understood it.
I think you can wait for another 2-3 weeks before going in for a re-surgery.
I would advice packing the wound with betadine dipped sterile gauze and the covering it with a field dressing so as to allow the wound to heal by secondary intention.
An antibiotic may be started if there is pus discharge or pain at the site.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi sir,
The doctor said that the pilonidal sinus will not allow the wound to heal as it will have continuous discharge of serum. Also there might be a possibility that some wall of cyst is left.in that case anyhow u will have to undergo surgery later.
Also there has been very low improvement since last 10 days by dressing.
I am confused with where to get this operated. The doctor which performed this missed the sinus in followups and he suspects there might be some wall left in the area. Should I consult him again and tell him about other doctors findings.
Thanks,
The doctor said that the pilonidal sinus will not allow the wound to heal as it will have continuous discharge of serum. Also there might be a possibility that some wall of cyst is left.in that case anyhow u will have to undergo surgery later.
Also there has been very low improvement since last 10 days by dressing.
I am confused with where to get this operated. The doctor which performed this missed the sinus in followups and he suspects there might be some wall left in the area. Should I consult him again and tell him about other doctors findings.
Thanks,
Brief Answer:
I suggest conservative approach for next 2 weeks
Detailed Answer:
Hi.
Surgery is of course an option. It depends on the operating surgeon whether he wants to go for surgery or not.
If the open wound is not obstructing the flow of secretions it need not be operated. However, if there is pain and swelling most likely there is pent up secretions inside and that needs surgery.
From here on surgery would only involve draining any pent up secretions/ debris from the cavity followed by gauze packing and field dressings.
Most likely it was a pilonidal cyst initially and since it was infected, it should not have been stitched.
It should have been just incised and gauze packed and allowed to heal over the next 2-4 weeks aided with oral antibiotics.
The stitches were removed after 2 weeks of surgery and its been just 1 week thereafter, I think you can try to manage it conservatively with dressings for another 2 weeks.
Pilonidal sinus may take up to 4-6 weeks to heal after surgery.
Regards
I suggest conservative approach for next 2 weeks
Detailed Answer:
Hi.
Surgery is of course an option. It depends on the operating surgeon whether he wants to go for surgery or not.
If the open wound is not obstructing the flow of secretions it need not be operated. However, if there is pain and swelling most likely there is pent up secretions inside and that needs surgery.
From here on surgery would only involve draining any pent up secretions/ debris from the cavity followed by gauze packing and field dressings.
Most likely it was a pilonidal cyst initially and since it was infected, it should not have been stitched.
It should have been just incised and gauze packed and allowed to heal over the next 2-4 weeks aided with oral antibiotics.
The stitches were removed after 2 weeks of surgery and its been just 1 week thereafter, I think you can try to manage it conservatively with dressings for another 2 weeks.
Pilonidal sinus may take up to 4-6 weeks to heal after surgery.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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