My baby brother (18 years old) had an abscess in his pilonidal sinus, near his butt, and he needed surgery to fix it, because antibiotics were doing nothing. His operation was yesterday, and he’s been home since last night with a fresh gaping open wound in his butt. It’s packed with gauze, which has to be changed at least once a day, and he’s in so much pain he can hardly move.
Are there any dopers who have firsthand experience with this sort of thing, and can pass along some words of advice? How long does it usually take to heal? What are some tricks on how to move with less pain?
He’s not looking forward to the months of gauze-changing, because it hurts. The nurse who came today was completely boggled at how huge the wound is, and when my bro heard her say that it was the deepest one she’d ever seen, he started bawling, scared about what that means for his recovery. The gauze-changing gets easier with time, right? And the wound gets less deep as it heals?
I’d say that you need a more sensitive nurse. That’s a terrible thing to say to someone who’s already in pain, discomfort and probably embarrassment. Aside from that, I have nothing to offer.
My coworker’s husband had this surgery done a few years ago. I can recall her saying that he was in considerable discomfort and it took him awhile to recover. But he is absolutely fine now.
It’s actually a pretty cool condition. Thought probably not so cool to the one suffering
It should heal in gradually from the bottom, and become less and less painful. The first week or so can be quite uncomfortable, and narcotic painkillers are generally appropriate for this sort of circumstance.
Once healing sets in, it hurts far less, and the individual can switch over to ibuprofen or acetaminophen or such. One just needs to make sure it’s properly cleansed and the dressing is changed regularly.
I’ve seen the cavities be as big as tennis balls after surgery.
He is on prescription painkillers - percocet, I think, and he says it’s doing a decent job with the pain. It’s more the long-term outlook that worries him. Having someone rip gauze out of a gaping hole in your bum, and then having them pack more stuff right back in, every day, for a couple of months, is not a pleasant prospect. It’s definitely a huge wound. Six inches long, and at least 2 inches deep. A lot of gauze fits in there. The nurse was trying to show my mother and me how to change the dressing, but we both got dizzy at the sight and couldn’t do it.
A matter of a week or two, QtM? Or longer? I realize that it’s probably different for each case, but if I can tell my bro with a little confidence that within a couple of weeks (and not a couple of months, as he fears), he’ll find himself in much better shape, then I think he’ll have an easier time of it.
Not having examined your bro or his wound, I can’t state anything about his case. I can only say that typically I’d expect improvement in a week or 10 days, to the point where the pain is not so demoralizing, but more of a nuisance, and won’t need narcotics. But his mileage may vary.
I’ve been there, at about the same age. It’s no fun, but it will get better. Either the gauze routine quickly starts to hurt less, or you just get used to it. I definitely did not need painkillers for very long.
The very very worst of it was on the first day after surgery that I had to pull the original gauze out myself. I had waited as long as they said I should, but when I pulled it out, I bled like crazy. I nearly passed out in the tub (from the sight of it, more than the actual blood loss). Fortunately my folks heard me calling and helped me out.
And yes, sensitivity is important. I still remember how the surgeon used the term filet when describing what he was about to do, and used the term yuck when I asked him how the procedure was progressing. :mad: Then again some light humor wouldn’t necessarily be out of order. Remember, it will all come out in the end!
My husband had one of those. I’d say that I could have fit two tennis balls into his wound, with half a bag of marbles to fill in the gaps. I got to clean and repack his wound twice a day. I only used gauze, not marbles or tennis balls!
It gets a LOT easier on both the patient and the nurse after a few days. However, it was quite some time before I felt like dealing with hamburger meat again. He stll has a scar, but it’s really not in a public area, and I only know it’s there because I know what to look for. The wound healed from the inside out, gradually filling in.
I had something similar done about 8 years ago. I think it’s the same procedure (it was described as a perirectal abcess) It came back a year or so after the first time but after the second operation it hasn’t bothered me since.
I had a much smaller incision than your brother to drain the abcess, I’m almost wondering if it was the same procedure. I can’t believe how huge you are describing the wound to be. Mine might have been 2 inches long and 1/2 deep. The gauze changing was over in a week or two and pain killers were only necessary for a week or so.
Get it lanced in an outpatient procedure was probably the worst pain I have even felt in my life. It was so painful it took my breath away, but I was glad to get it done as I was in horrible and was starting to get a serious fever.
I’m surprised they “packed it” with gauze as normally you install a bit of gauze inside the wound for a drain wick then put a dressing on top of that to catch the drainage, and that would be changed daily. I can’t imagine packing and unpacking the wound every day.
No, that’s what they do for pilonidal cysts. It makes a big crater. And said crater needs packing. Not a wick.
It’s different with an abscess. There you just have to open up the abscess pocket, and make sure the pocket can drain. Even then sometimes the wound must be enlarged and packed.
Yeah, I’d say that the wound on my husband’s butt could be called a crater. I called it several other things, as well. I was told that I had to pack it so that the sides wouldn’t heal together prematurely and get infected again.
I didn’t enjoy my nursing duty. I got my revenge, though, when I had a hysterectomy and developed abcesses myself, which needed to be unpacked, cleaned, and repacked a couple of times a day. My husband’s face can turn GREEN sometimes.
One more suggestion. Perhaps the doctor or hospital can put your brother in touch with another patient who has already been through this? It might be reassuring to hear that it does get better, and it helps to hear it from someone who has been there.
pilonidal.org has some good info and a message board, although it should be noted that most people who post are the people who have problems. It’s unlikely that someone would post and say “Hoh-da-le doh-dah-lee, friends and neighbors! Just wanted to pop in and say I luuuuuuuuuuuuuuuuuuuuuuv packing my wound!!” So, you’ve got to take that into consideration, but they are a good resource for pilonidal patients.
