Sinus pilonidalis

Preparation:

  • Fasting 6 hours before surgery. Usually from midnight before surgery. (Do not eat solid foods or drink fluids).
  • Painkillers: 1 hour before the operation , take the painkillers Panodil, Paracetamol or Paratabs 500 mg. If you weigh less than 70 kg then 2 tablets and otherwise 3 tablets. If you have liver problems, do not take this medicine without talking to your doctor.
  • Shower the night before surgery and also on the morning of surgery. Wash with plain soap. 
  • For infection prevention reasons, do not moisturise the surgical area or apply depilatory cream/wax to the surgical site one week before surgery. If hair needs to be shaved from the surgical area, this is done at the beginning of surgery by operating room staff.
  • No creams or skin emollients should apply to the surgery area on the day of surgery.
  • Avoid use of anticoagulants such as acetylsalesylic acid (magnyl, codeimagnyl, cardiac magnyl, etc.) and any NSAIDs (e.g. Ibufen, Ibumetin, Naprox, Voltaren, Vóstar) for at least 5 days prior to surgery. Fish oil and omega fatty acids are blood-thinning and should be stopped one week before surgery. If you are taking the medicine Warfarin (Kovar/Waran/Dicumarol) you will normally have to stop taking it 6 days before surgery or be given special instructions. The same goes for medications; Grepid, Clopidrogel and Plavix which are anticoagulants. Patients taking antihypertensive and/or cardiac medicinal products are advised to take them on the morning of surgery with a sip of water. The use of a contraceptive or menopausal pill does not need to be stopped. People with diabetes who are using insulin need to talk to their anaesthetist a few days before the operation (tel. 590 9213).
  • The operating room has locked compartments for valuables/telephones etc. Skurðstofan ehf does not guarantee any loss or possible damage to personal effects. The use of smartphones during recovery is prohibited. All recording/distribution of audio and video from the operating theatre as well.
  • Upon arrival at the operating theatre, you will meet with a surgeon and anesthesiologist who will explain the main aspects of the procedure and advise on aftercare. You get a gown and disposable underwear to wear and draw on your skin. All patients must sign informed consent prior to the procedure. 
  • If you have known allergies to medicines, plasters, antiseptics, etc. it must appear before the operation.
  • The Icelandic Health Insurance (SÍ) pays for the operation mostly for those with health insurance in Iceland. Payment is collected for the operation. You can pay by credit card or credit card, but not by bill. 

After the procedure: The vast majority of procedures are performed under anaesthesia or local anaesthesia with a concomitantly administered intravenous relaxant. After surgery you will be able to recover in the recovery unit for 1-2 hours and when you feel comfortable and authorised by an anesthesiologist you can go home. Somebody's got to come get you. Patients are not considered fit to drive until the following day. 

Pain: During the first few days, you can expect discomfort in the surgery area. Painkillers are recommended if needed and are available without a prescription at pharmacies (Paracetamol/Panodil 500 mg, 2 tbl four times daily) or with a prescription (Parkodine).

Laceration: Lacerations are sometimes left open and allowed to heal up. In such cases, the wound needs to be replaced regularly. Later, rinse it with soap and water regularly (in the shower). Help can be obtained at a clinic with replacements of the wound over time. However, it is necessary to appear for surgical observation for rotations initially after surgery and later every week or two weeks to monitor appropriate healing. 

Complications:  Bleeding into the surgical wound and infections may occur. When bleeding usually occurs, pain occurs and the wound bulges out, and over time bruising occurs in and below the wound. When the wound is stitched, there is some risk of infection. Symptoms of infection include pain and tenderness in the wound and fever. If you suspect a larger bleeding or infection, contact your doctor. It should be noted that this disease has a fairly high recurrence rate. Therefore, it can never be excluded that the person will need to undergo treatment for the disease again later in life. 

Work: Absences from work are individual, depending on the scope of the activity and individual work. It is not unusual to be absent from work from one to three weeks after the operation and longer in rare cases. Certificates for work are given upon re-entry.

Stefán E. Matthíasson dr. med.
Diagnosis and treatment of surgical and vascular diseases