Nutrition and Vitamins for Pilonidal Wound Healing
High protein diet, vitamins and supplements before and after pilonidal cyst surgery
High Protein Diet
Proper nutrition is important to promote wound healing. Patients should make a real effort to stay on a high protein diet. This means the diet should consist of lots of meat, poultry, fish, eggs, soybeans, nuts, etc. Carbohydrates, such as bread, cookies, pastries, rice, potatoes, etc, are not as important – and a high carbohydrate diet will cause a person to gain weight. This can be a real problem in patients with open pilonidal wounds who may have their activity restricted because they are not burning off as many calories as they normally would. Surprisingly, fats and oils are less of a problem than carbohydrates regarding weight gain – but the goal should be a high protein intake, low carbohydrate diet with lots of healthy fats.
Exactly how much protein a person needs in order to be on a “high protein” diet is not an exact number. It depends on your age, gender, weight and goals. But, 50 gms of protein is a reasonable ballpark number. Many nutritional supplements will list the amount of protein they contain. As you read the labels, look for lots of protein, and minimal carbohydrates. Here are some basic numbers to help you:
Amount of Protein
1/4 lb hamburger 30 gms
4 oz chicken breast 25 gms
4 oz lunch meat 20 gms
1 large egg 6 gms
5 oz tuna 33 gms
Peanuts, 1/2 cup 20 gms
Carnation “Breakfast Essentials” Drink, 8 oz bottle 10 gms
Ensure Plus Nutrition Shake, 8 oz bottle 13 gms
Special K Protein Cereal, 3/4 cup, 10 gms
Whole milk, 8 oz, 8 gms
Note: Although dairy products have a good amount of protein, they are not helpful if you are trying to lose weight.
Not So Good Sources
1 cup spaghetti 8 gms
1 bagel 6 gms
1 cup cooked rice 3 gms
1 banana 1 gm
Nature Valley Crunch Granola Bars, 2 bars, 4 gms
Honey Bunches of Oats Honey Roasted, 3/4 cup, 2 gms
Strawberry Pop-Tart 2 gms
Juven, one packet, 2.5 gms
Vitamins and Supplements
There used to be controversy regarding the value of additional supplements in a well nourished individual. But, because of issues with vitamin depletion in our current food supply, even a seemingly well nourished person can be deficient in certain of the vitamins which can adversely effect pilonidal wound healing. The vitamin content of our food supply is not what it used to be! Since it can be difficult to determine vitamin deficiencies, it may be a good idea to supplement a healthy diet with the additional vitamins, minerals, and amino acids listed below, which are specifically involved with the healing process. This is especially important for patients who have had problems with prolonged wound healing. For more information, here is a link that discusses vitamin depletion in our diet.
Because antibiotics are used after this operation to prevent infection, it is recommended that patients take a good probiotic while on antibiotics, and for several months after the surgery. I recommend Ther-Biotic Complete, from Klair Labs, one capsule daily, as an excellent choice.
But, please note that if you have a pilonidal wound in an unfavorable position (deep in a cleft in the midline) it may not heal in spite of maximal nutritional support or wound care. If you are dealing with a difficult wound, this nutritional advice certainly may help – but it may not be the whole solution. Surgery may be needed to correct the position of the wound. In general, wounds that haven’t healed in three months, or have healed and opened up again – need surgery to flatten the cleft.
If you are coming to see me for surgery, I would like you to start these vitamins and supplements as long before the surgery as possible, and plan to continue them for six weeks after the surgery (or until the incision has healed):
Vitamin A 10,000 units/day
Vitamin C 1000 to 2000 units/day
Zinc 15 mg/day
Magnesium 120-250 mg/day
Arginine 3000 mg/day
Glutamine 3000 mg/day
Glucosamine 1000 mg/day
Vitamin D with K2 5000u/100 mcg/day
Klaire Labs Ther-Biotic Complete Probiotic
These can be purchased through Amazon or found in a vitamin/supplement store.
If you are a patient of Evergreen Surgical, and you prefer, we have a ordering template set up at https://www.fullscript.com. In order to have use this service, you have to be registered as one of our patients. Contact Angela, at our office to set you up as a patient, and you will have access to this. It has already low cost supplements, and as our patient you will get and additional 10% discount. We do not make money from this, but offer this to out patients as a way for them to get quality supplements at a good price. Feel free to order other vitamins and supplements
If you use Fullscript:
Look for the prescription template Pilonidal Surgery Supplements 2020, and it will have everything you need.
If ordering from Amazon this group of products will meet the necessary requirements:
Metagenics Phytomulti 2 caps/day
Natrol L-Argenine 3000mg tabs 1/day
Pure Encapsulations L-Glutamine 1,000 mg 3 caps/day
Pure Encapsulations Glucosamine Sulfate 1,000 mg 1-2/day
Vitamin K2 + D3 (Sports Research Brand) 100mcg K2 + 1000u D 1 softgel/day
Klaire Labs Ther-Biotic Complete Probiotic
What about Juven for pilonidal healing?
Juven is marketed as a “Therapeutic nutrition powder for wound healing” and is sold by Abbot Labs. It comes in 23.0 g packets and is meant to be a nutritional supplement when mixed with juice or water. The recommendation is two packets per day.
Here is the nutritional composition of one Juven packet. As you can see it has several of the things that I recommend; but in lesser quantities on some things, and greater quantities of others.
- Calories 80
- L-Arginine, 7000 mg
- L-Glutamine, 7000 mg
- Protein (Collagen) 2.5 g
- Carbohydrate, 4.2 g
- Sugars, 0 g
- Vitamin C, 300 mg
- Vitamin E, 15 mg
- Vitamin B12, 1.2 mcg
- Calcium, 200 mg
- Zinc, 9.5 mg
- Calcium Beta-hydroxy-Beta-methylbutyrate, 1.5 g