Concerns Over Post-Operative Healing of a Pilonidal Cyst Using Rhomboid Flap Technique
Hello, I'm a 27-year-old male, standing at 181 cm and weighing 115 kg. I’m Caucasian and have a somewhat hairy physique. For several years, I have been on low-dose pain medication and daily loperamide due to my medical history. Images are attached at the end of this post for reference. I underwent surgery on June 12 of this year to address a pilonidal cyst that had returned after a decade. As a solution, the doctors opted for a rhomboid flap surgery. Post-surgery, I was hospitalized until June 17, after which I returned home. My mother was instructed by the medical staff on how to care for my wound and the stitches each day. She takes photographs for monitoring progress. They provided us with guidelines on how to facilitate healing, such as avoiding sitting (except for bathroom use) and not lying on my back. It was also advised to refrain from using soap on the affected area, though rinsing it during showers is acceptable. About a week ago, I began experiencing increased discomfort; while I rated my pain at 1-2 during my hospital stay, it has escalated to about 3-4 now. The pain is concentrated mainly at the top of the swollen area and at the ends of the stitches, and I’ve noticed that movement has become more uncomfortable. The sensation is often described as tight, with considerable pressure, and normal movements can provoke pain, which I did not experience while in the hospital (where I had two vacuum drains in place). A follow-up appointment is scheduled for next Tuesday—four days from the date of the last photo I’ll be sharing. I would appreciate any insights regarding how the incisions appear. Does this look like a situation that requires immediate medical attention, or is this part of the expected healing process? The photos depict the area in chronological order over just a few days, and I've included some images showcasing post-shower preparations along with Betadine stains. Lastly, aside from feeling slightly fatigued and warm due to the weather, I haven't experienced any fevers associated with this condition. Thank you for your thoughts!
Answers (1)
6/27/2025, 6:01:30 PM
OpenHealth AI
It sounds like you're experiencing some heightened discomfort following your rhomboid flap surgery for a pilonidal cyst, which understandably raises concerns about your healing process. It's important to address continuing pain post-surgery as it can be a normal part of recovery, but it can also signal complications.
Summary of Main Points:
- Increased pain and discomfort can be a normal part of the healing process but should be monitored closely.
- Your upcoming follow-up appointment is crucial for professional evaluation.
- Immediate signs to watch for include changes in swelling, drainage, or fever.
Explanation: Recovery from pilonidal cyst surgery can involve varying levels of discomfort as your body heals. It’s common to have some pain as swelling decreases and tissues begin to heal. However, an increase in pain, especially localized to the incision area, might indicate a complication, such as infection or an issue with how the skin is healing. Your mention of tightness and pressure is also noteworthy but could be part of typical inflammation.
Given that you’ve had successful management of your pain levels previously, a rise to a 3-4 on the pain scale warrants your attention. Monitoring how your symptoms progress up to your follow-up next week is essential.
Next Steps:
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Wound Monitoring: Continue to observe the appearance of the wound. Look for any signs of increased redness, swelling, or drainage that may have a foul smell, which could indicate infection.
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Pain Management: If pain increases to a level where daily activities are significantly affected, consider taking your prescribed pain medications as instructed, ensuring it aligns with your ongoing regimen.
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Mobility Adjustments: Minimize movements that exacerbate pain, particularly heavy lifting or prolonged sitting. Consider gentle changes in position while seated or lying down to alleviate pressure on the area.
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Hydration and Nutrition: Maintain hydration and balanced nutrition to support healing. Avoid excessive heat and moisture to the surgical area, particularly in hot weather.
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Prepare for Your Appointment: When you visit your follow-up appointment, bring the photos for comparison and discuss your concerns. Note any changes in pain intensity or symptoms since your last visit.
While it’s good to be vigilant, keep in mind that healing takes time, and slight fluctuations in discomfort can be normal. However, if you notice any concerning changes or an increase in symptoms, don’t hesitate to call your healthcare provider for advice before your scheduled visit. Keep taking care of yourself, and I hope you find some relief soon!
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