Help! I just had a wide excision!

If you are a patient who recently had a wide excision, and now have an open wound, you may wonder what you’ve gotten into!

It is important to know what your options are at this point. Often, surgeons are not completely upfront about the length of recovery required after this procedure, and they minimize the amount of pain and difficulty involved in dealing with an open wound for months and months.

The reality of the situation is that the length of time a wound takes to heal is very variable. It can take 2-4 months in the best situation. I saw a patient today in whom it took a year to heal (but then the pilonidal disease recurred). I have seen other patients in whom it never healed. Dealing with an open wound for months can be a nightmare for some patients. A vacuum suction device (Wound VAC) may speed up healing to some degree, but the gluteal crease is an awkward location for something like this, and a vac is noisy, uncomfortable, awkward, smelly, expensive, and embarrassing.

So – what can you do at this point? As I see it, you have two choices:

1- Continue with the open wound care, and keep your fingers crossed that it heals and stays healed. But, be aware that you’re committed to a prolonged period of dealing with an open wound, and the recurrence rate for future pilonidal problems is significant.

2- Consider getting a cleft lift. Often is not necessary to wait for the current surgery to heal in order to do this – but it depends on how much was removed during the excision. I had one smart patient literally contact me from his hospital bed after a wide excision asking if I could help. We had him fly here within a few days, and performed a successful cleft lift. The following link will take you to a three part image showing the preoperative, immediately post-operative, and six weeks post-operative appearance for this patient. But, be forewarned – it starts with an image of a  15 cm open wound- so don’t click unless you’re willing to see it. Image Link.

We have also performed, what we call, “Wound Vac Rescue” – where patients on a wound vacuum device contact us, and we immediately get them off the wound vac and perform a cleft lift.

The advantage of this is that it saves months of the discomfort and embarrassment from an open wound, the cost of expensive dressings and multiple clinic visits, and it gets you back to life, school, or work much faster. The disadvantage is that you have to travel to Wisconsin for a few days. Many patients have told us that in spite of the travel costs, coming to see us was less expensive than wound care. We know it is certainly the faster and more efficient option.

We have an extensive experience with this situation and are experts in getting the surgery set up quickly and getting you back to normal. All you have to do is click here to contact us and we will become part of your team.

So, understand you do have choices, and this is all about you – not your surgeon. Do your research, and get the best treatment!

Dr Immerman

The Water Street Bridge over the Chippewa River, Eau Claire, WI