Pilonidal sinus surgery


Q: Hello . i had 4 sinuses in my cleft lift , so i did closed surgey in 5 march , my wound has 3 stitches , i feel great pain , but i can do push ups pull ups easily , i even walked for 10 hours today , i will be removing the stitches this week in 20 march & i want to know when would i be able to go back to the gym , jogging...... dimensions of the piece that was taken from my body = 4.5*1.8*1.8 cm the pain i'm feeling isn't in the surgery wound it's close to it , it's a small cut that i think happened because of the pressure of the stitches , it hurts so bad . the nurse told me that it's just an irritation . is it normal??? waiting for your replies , thanks in advance sorry for my bad english gender : male age : 20

Symptoms:  Pain and reddness

A:   Hello,
Thank you for your medical query at AskTheDoctor.com
I understand your concern.

From your history, you have undergone cleft lift surgery on 5th march 2015 and there are 3 stitches over the surgical site. Significant dimension of 4.5 cm tissue was taken out and skin flap was raised from any side gluteal flap either right or left and crossed to cover the wound and sutured after approximating the deeper tissues by sutures. So you can understand two things:
1) There are deeper absorbable sutures along with the 3 skin sutures and
2) As the deeper structures are approximated and skin flap is raised and crossed over from the normal location, there is minimum tension associated with the repair. So adequate rest to the wound has to be given so that it heals fast. As you have not mentioned about any drains, so, I presume that either drain was not kept or it was removed.

Post-operatively you are advised to sit on the wound site as well as you can do walking exercises but walking for 10 hours is definitely strenuous as you can have lot of sweating leading to wound infection and the strain of walking for 10 hours can put tension on the wound and can lead to gaping of the wound resulting in delayed primary healing or secondary suturing at a later date. Sit ups,push ups and pull ups to be strictly avoided for 1 month as these are strenuous exercises and can lead to giving way of sutures both of the skin and deeper layers leading to gaping or delayed wound healing. So push ups/pull ups to be avoided for 1 month. By that time wound will get healed and you can go back to your rigorous physical exercises.

Now regarding the cut near the surgical incision you are justified to be concerned as it can be a tear on the skin flap due to overexertion and tension over the surgical site and skin flap. Kindly show to your treating surgeon when you go for suture removal and follow his advice, however, restraining from strenuous physical activity will be sufficient for the tear to heal.

If after showing to your surgeon he feels that there is minimal wound infection, inflammation or oedema over the operated site/flap tear, a course of antibiotics as per your treating surgeon's choice and Tab. Chymoral Forte can be taken thrice daily to reduce the oedema will be sufficient.

Keep the perianal area clean and you also need sitz bath three times daily.

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