pilonidal cyst bleeding months after surgery pilonidal cyst bleeding months after surgery

The differential diagnosis for PSD by the American Society of Colon and Rectal Surgeons includes a furuncle (staphylococcal infection of the deep hair follicle), osteomyelitis, and anal disease.9 Surgical intervention with incision, drainage, and curettage of an acute abscess is associated with a 40% to 60% recurrence rate.2,10 A chronic or recurrent sinus will require wide excision and primary or secondary closure.8 All 3 approaches have risks of recurrence (Table 2). Int J Colorectal Dis 1995; 10: 1616. Although the evidence does not support the use of Sitz baths for wound healing or pain relief, a systematic review23 identified that they do improve patients overall satisfaction. The Surgeon did a cleft lift and stitched my wound up after the operation. The one I got him worked well, but he was embarrassed to take it to class with him. Pilonidal derives its name from Latin- pilus meaning "hair," and nidus meaning "nest." The name "pilonidal disease" has been attributed to R.M. Arch Surg 1994; 129: 9148. There are, however, other causes of. All rights reserved. When this happens, you may need a more extensive surgical procedure to remove the entire cyst, not just the internal contents. Unfortunately, pilonidal cysts can come back after surgery. A pilonidal cyst may also cause complications, including the following: In rare instances, pilonidal disease can progress into squamous cell carcinoma, a type of cancer. The doc told me that it was normal - called serius fluid, which can happen after surgery. May 3rd, 2013 I had the operation done. As explained by Dr Parameshwara, thetop pilonidal cyst treatment doctor, people who have recurrent pilonidal cysts often develop chronic wounds and draining sinuses. It takes the pressure off your tailbone. What should I sit on that'll help relieve the pressure so I may be able to sit for a fair amount of time if I'm at college and I'm. this cycle keeps repeating every few weeks now.? Abstract Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Theyll sew the edges of the cut to the wound edges to make a pouch. The most common treatment is watchful waiting, unless the cyst is found to be large or is causing symptoms. A doctor can diagnose a pilonidal cyst by carrying out a physical exam and asking the person questions. The only way to get rid of a pilonidal cyst is through a minor surgical procedure. After participating in this educational activity, the participant should be better able to: 1. Bacteriology and complications of chronic pilonidal sinus treatment with excision and primary suture. These dressings are easy for individuals to apply and cost-effective if frequent home dressing changes are required between healthcare provider visits, enabling the client to keep the area dry and reduce friction, and local dressinginduced external pressure. It affects about 70,000 people in the US annually and is more common in men than women. Part one: the literature review. My son had something similar -- we decided it was chafing where the seam on his pants was rubbing the soft, tender new skin of the scar. If this is happening see your surgeon for eval and possible re-excision of the. Sibbald RG, Woo K, Ayello EA. Once everything has been removed from the cyst, theyll pack the wound with sterile gauze or close it with stitches, depending on the location. Symptoms of a pilonidal cyst include: (1) Pain or tenderness. avoid wound contamination and match the contours of the natal cleft, sealed at all edges. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://pubmed.ncbi.nlm.nih.gov/26094093/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292120/, https://wjso.biomedcentral.com/articles/10.1186/s12957-017-1129-0, https://www.ncbi.nlm.nih.gov/books/NBK557770/, https://fascrs.org/patients/diseases-and-conditions/a-z/pilonidal-disease, https://www.nhs.uk/conditions/pilonidal-sinus/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6536872/. Miller D, Harding K. Pilonidal sinus disease. 7. Loosely secured dressings roll or bunch and will cause excessive trauma to the wound and periwound area, unless the patient is able to perform self-care as per No. They may use general or regional anesthesia to manage your pain. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. The owner of this site is using Wordfence to manage access to their site. People thought they were because of irritation from riding in bumpy Jeeps. They packed it only twice and let it heal after that without any packing. 6. It may happen if: The area of the first abscess keeps getting infected again. to maintaining your privacy and will not share your personal information without These PSWs have costly financial consequences to the healthcare system and negatively affect the quality of life of the individual with the wound. A 15-year-old boy had an elective excision of an extensive pilonidal sinus, left to heal by secondary intention. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. To learn more, please visit our, like an emergency, but I would recommend you call the doctor who is seeing you for the. WebMD does not provide medical advice, diagnosis or treatment. Email : wecare@smileshospitals.com I soften up the dried spot of the scab and clean it now all the time. Advantage -- Its a simple procedure done under local anesthesia, meaning just the area around the cyst is numbed. The presence of 3 or more signs is an indication to include topical antimicrobial agents as part of the local wound care. Engaging clients early in their care can be quite challenging. Periwound skin in the natal cleft often contains bacteria, such as staphylococci. Several years ago i had a pilonidal cyst that had to be cut open and and drained. Healthline Media does not provide medical advice, diagnosis, or treatment. Advantages -- This is outpatient surgery under local anesthesia. Your appointment should be _____ week(s) following surgery. Abstract Pilonidal sinus disease (PNSD) challenged surgeons for decades. In this article, learn about ingrown, Pilar cysts are fluid-filled lumps that tend to appear on the scalp. Until you have completely healed, you will need to avoid . Sory ,just to add up..I guess if the scar is iritated then "only scar "is a bit redish or bit bubely Hello. Signs of surface bacterial damage are included in the NERDS mnemonic: Pain in PSWs can be a factor in reducing the individuals ability to attend school or continue working, or refusing to have the wound packed. Superficial critical colonization is due to damage caused by bacteria on the surface of the wound that leads to delayed or stalled healing of a PSW. Increased bacterial burden and infection: the story of NERDS and STONES. A purpuric rash is made up of small, discolored spots under your skin from leaking blood vessels. Armstrong JH, Barcia PJ. What is the recovery time after pilonidal sinus surgery? Reviews have shown that the Karydakis flap procedure results in lower rates of pilonidal disease recurrence and complication than standard excision methods. A single copy of these materials may be reprinted for noncommercial personal use only. J Wound Care 1999; 8: 30910. Discover how to lessen their appearance or get rid of them permanently. Our website services, content, and products are for informational purposes only. <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> First Principles of Gastroenterology: The Basis of Disease and an Approach to Management, [Online] 1997. Bascom JU. Marks J, Harding KG, Hughes LE. 30. Swelling. The intention was to aid the epithelium to migrate across the wound bed down into the deep fold of the natal cleft, while preventing fecal or other contamination of the wound. It typically forms at the top of the buttocks, right between the cleft, which separates the two cheeks. Now, about 3 or 4 months after surgery my scar area is a bit swollen, red, warm and hurts a little. For this dressing frequency, the more expensive moisture retentive dressings can be consideredfor example, adhesive foams, absorbent composite dressings, or semipermeable films with nonwoven soft gauze. These questions may include: The doctor will also assess the persons family medical history. For neuropathic pain (burning, stinging, shooting, stabbing), tricyclic agents (especially nortriptyline, desipramine), gabapentin, pregabalin, and carbamazepine are useful. But popping a pilonidal cyst wont fix the problem. I did this and was fine within a day. 5. You are not alone, stay strong and remember there is light at the end of the tunnel. Of course, some folks who Should i be worried that a newly found pilonidal cyst has been bleeding for about a week, should i seek medical attention immediately? After 4 days, you may shower and allow the water to rinse over the area. 9319-488-973 Book Free Appointment Shower after pilonidal cyst drainage You can shower the day after surgery. Pilonidal cysts are treated with a simple in-office procedure. Treatment A pilonidal cyst is usually treated in your health care provider's office. Pilonidal sinus disease: the conservative approach. There is no relation to the rectum at all. The NERDS and STONEES mnemonic first published in the study of Sibbald et al18 and validated by Woo and Sibbald19 outlined clinical features that increase the incidence of superficial critical colonization (NERDS) and deep infection (STONES later revised to STONEES). You are using an out of date browser. Staphylococcal infections of open granulating wounds. J Wound Care 1994; 3 (1): 4234. Harris CL, Holloway S. Development of an evidence-based protocol for care of pilonidal sinus wounds healing by secondary intent using a modified reactive Delphi procedure. Looking for ways to manage pilonidal sinus after surgery? If you had a closed excision, and begin having bleeding, drainage, or wound separation from a part of the incision that is down in the gluteal cleft - you may have trouble getting this to heal. Iodine has the ability to penetrate biofilms because of its small molecular size, but it may be proinflammatory. Pilonidal means "nest of hair," and doctors sometimes find hair follicles inside the cyst. Current Therapy in Colon and Rectal Surgery [online]. 16. Standard excision methods typically remove the affected sinus but do not pull skin folds over the wound area for healing. prevent wound bed cooling and disruption. Pilonidal cysts are more common in males than in females. You can learn more about how we ensure our content is accurate and current by reading our. at first it would bleed for a week stop for a few. Clinicians need to remember that persons with chronic wounds for more than 1 month often have Gram-positive, Gram-negative, and anaerobic organisms playing a role in the bacterial damage. Common symptoms of pilonidal cysts include: At present, the exact reason why pilonidal cysts develop is unclear. The focus is that the wound and the donor area must be carefully stopped bleeding. Steps that people can take to reduce the risk of pilonidal cysts developing include: People who are overweight may also find that weight loss reduces the risk of cysts developing or recurring. If you are a WordPress user with administrative privileges on this site, please enter your email address in the box below and click "Send". I got his at amazon, I can send you the link if you'd like. Pilonidal cyst surgery is typically a minor outpatient procedure. WHOs Pain Ladder. Hydrogels should be selected for dry or thick-slough areas, keeping in mind that the whole cavity is not to be filleda small amount in the base of the wound is sufficient to provide needed moisture with the secondary dressing maintaining wound contact. This will fade and become softer with time. Fierheller M, Sibbald RG. For a better experience, please enable JavaScript in your browser before proceeding. 23. In this procedure, a doctor will remove any hair or hair follicles from the cyst and . I emailed some pics to my surgeon and he suggested I take 5 days of antibiotics (Augmentin 625 mg twice a day) with an anti inflammatory (I took serrapeptase which is a natural anti inflammatory and 10 times stronger and safer than Advil/Ibuprofen) alongside and probiotics (to counteract the antibiotics). You can just place a dry dressing on the area after your shower. Ever since then I haven't had any pain or what seems to be a recurrence. Usually keeping this such as hair strand underneath that cause periodic. WhatsApp : +91-9844229888 Although these data are currently being collected, the staff report decreased average length of stay for patients adherent to the PSW protocol. Honey is available in alginate, hydrocolloid, and hydrogel formulations with several antimicrobial actions including hyperosmolar properties that may be neutralized when the dressing becomes oversaturated. Generally, the outlook for anyone with a pilonidal cyst is excellent, with a complete cure being possible. Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, mayoclinic.org/diseases-conditions/pilonidal-cyst/symptoms-causes/syc-20376329, uvahealth.com/services/dermatology/pilonidal-cyst, healthyhorns.utexas.edu/HT/HT_pilonidalcyst.html, fascrs.org/patients/disease-condition/pilonidal-disease, Pilonidal Cyst Surgery Procedures and Recovery, 5 Recommended Stretches to Soothe a Sore Tailbone, Daniel Bubnis, M.S., NASM-CPT, NASE Level II-CSS, Overview of Purpuric Rash, a Symptom of Some Conditions, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, How to Get Rid of Dark Circles Permanently. so what I've been doing is this As soon as I start to feel any discomfort I begin to take hot(not to hot) bath with Epsom salt(it reduces swelling and kills bacteria) after about a 30 to 40 minute soak I shower normally and then put vitacilina(petroleum based antibiotic cream it's OTC) and withing a few days it's all gone. They can perform these under local or general anesthetic. Marks J, Harding KG, Hughes LE, Ribeiro CD. The most accepted theory for the cause of thes Uncomplicated cysts can often be managed with shaving the area. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Saudi Med J 2005; 26: 2858. Perhaps this is what it is? Bad smell from the pus. Fecal contamination of the dressing and the wound contributes to delayed PSW healing. 8. The clinician needs to assess how each dressing manages moisture (absorbs, donates), along with its moisture vapor transmission rate. (2015). Some error has occurred while processing your request. It's NOT a donut, as the hole is not in the middle, but in the back. 1 0 obj A pilonidal sinus wound (PSW) (pilonidal cyst, sacrococcygeal fistula) is a cystic structure that contains hair and skin debris and may become secondarily infected.1 Affected individuals present with pain, pus, and swelling near the natal cleft of the buttocks or in the midline of the sacrococcygeal area of the back. The symptoms of a pilonidal cyst include: Pain, redness, and swelling at the bottom of the spine. This can relieve pain and itching. I also dont understand, on the page i linked above they explain. Well, what else could it be? Best Doctor For Fistula Surgery In Bangalore? The Karydakis flap procedure involves surgically removing affected sinus tissue and creating a vertical incision to one side of the original opening. The fear of recurrent infection and fear of wound deterioration reduce the quality of life. I do stand in the shower with the water at my back. Simply by walking, a rolling or drilling effect occurs; the buttocks move against each other, complicated by suction in a deep cleft. If that is the case, you should look at my page Help! Pilonidal cyst surgery recovery usually goes smoothly, but sometimes the surgical site develops an infection. People are also most likely to develop pilonidal cysts between puberty and 40 years old. What is a pilonidal cyst? Highlight selected keywords in the article text. Minimal post-surgery bleeding or drainage is normal After the surgery, it is common to experience a little bleeding or drainage from the wound. PHMB foam and gauze may also provide moisture balance for PSWs, with the foam having a longer wear time. Home treatments can relieve discomfort from a pilonidal cyst. The pain was horrible. After the incision has healed, you will have a scar where the cyst was removed. Antibiotics that messed up my stomach, cream that seemed to help. Its called a pilonidal cyst, and it can become infected and filled with pus. <> A sore tailbone can make sitting and walking painful, but these yoga-inspired stretches will get you moving comfortably in no time. BUT he did use it in the car for a while. Most people can go back to work and most activities after 2 to 4 weeks. For potential or actual medical emergencies, immediately call 911 or your local emergency service. It also lets the doctor make a smaller, shallower cut so that you dont need to take out and repack gauze daily. Wolters Kluwer Health In open wounds, it is critical to carefully examine the wound and wound edge at each visit to identify and remove hairs or foreign bodies. Stop swimming or soaking-baths for about 2 to 3 weeks after pilonidal sinus surgery. These lumps are usually harmless and often require no treatment, though they may, Learn how fluid-filled lumps known as cysts can form around an ingrown hair. Generated by Wordfence at Sun, 5 Mar 2023 2:25:42 GMT.Your computer's time: document.write(new Date().toUTCString());. Keep your follow-up appointments with your doctor so they can see how your cyst is healing. keep the dressing clean and dry at all times. JCN 2003; 17 (7): 2530. I still have my open wound and my sinus has come back, frequently getting infected, no matter how clean I keep the area. For these, please consult a doctor (virtually or in person). Friction on the ingrown hair from sitting or rubbing can irritate your skin and cause the cyst to form. the wound was not fully healed and one day later it won't stop bleeding. The overall cost of care versus the cost per visit needs to be carefully examined in order to meet patient-centered concerns. Most often it occurs between puberty and age 40. A person with a pilonidal cyst may experience swelling, pain, and skin discoloration in the affected area. This typically happens when hair or other debris fills the sinus. If your incision was stitched closed: Keep the site dry and clean for 4 days after surgery. Pilonidal Support Alliance. Your doctor will numb the area with a local anesthetic and then make a small cut to open the cyst. Might be an undissolved stitch! Mayo. I've got a pilonidal cyst that's been bleeding for a few days, i'm on a very long wait list to see a specialist, how can i at least slow the bleeding. Pilonidal cysts can lead to significant discomfort if they become infected. 27. Treatment may include antibiotics, hot compresses and topical treatment with depilatory creams. Best thing to do if there's any doubt and it's bothering you tho would be to see your doctor. Expected healing rates vary between 8 and 10 weeks or longer. 2. The first line of treatment for ovarian cysts is diagnosing the specific type of cyst using ultrasound and blood work. During a Limberg flap operation, a doctor will make a rhomboid-shaped incision over the sinus and remove all affected tissue from the area. You are using an out of date browser. Dr. Michael Zadeh answered General Surgery 19 years experience Cyst on tailbone: A pilonidal cyst is a cyst that develops in the midline of the tailbone near the cleft of the buttocks. It can be caused by conditions that range from mild, Learn all about dark circles under your eyes. If youre job requires you to sit for most of the day, try to set aside a few minutes every hour to stand up and take a quick walk. BTW - im 29. In addition, consider removing any hair you have growing near the top of your buttocks. 2 0 obj Another theory is that pilonidal cysts appear after a trauma to that region of your body. Anecdotally, the authors have seen improved client outcomes from regularly shaving the periwound area. How should you treat an ingrown hair cyst? Is the scar "off-midline"? Recovery from this type of surgery can take weeks or months to heal, is extremely painful, and often results in a recurrence. But after 3 months, and repeat trips to the surgeon and a wound care center, who also treated my wound with bandages - the surgeon told me I would have to under my second surgery for a sinus. The body creates a cyst around the hair to try to push it out. Ms Laforet has disclosed that she is/was a consultant/advisor to Hollister; was a consultant/advisor to Systagenix; was a member of the speakers bureau for 3M and Systagenix; and is a stock shareholder in 3M. Department of Surgery Section of Colon and Rectal Surgery Tel: (212) 746-6030 . The doctor makes a cut to remove the cyst and some of the tissue around it. Disadvantages -- It takes about 6 weeks to heal, and you need a doctor specially trained in the technique. To enhance the learners competence with knowledge of 12 common mistakes in pilonidal sinus care. It is more common in men than in women. Advantage -- You dont need to pack gauze because your doctor fully closes the wound right after surgery. Lang DSP, Tho PC, Ang EN. Negative-pressure wound therapy was used for the first 8 weeks at which time the 8-cm cavity was completely filled. Try applying a hot, wet compress to the cyst a few times a day. Oftentimes, wound-associated pain is a combination of both types of pain. Canadian Association of Gastroenterology, 3rd edition,1997. Ms Harris has disclosed that she has no financial relationships related to this article. Carrying extra weight can also make you more prone to developing pilonidal cysts. For a pilonidal cyst in which infection has created an abscess : Your doctor will likely cut open and drain the cyst. Now, about 3 or 4 months after surgery my scar area is a bit swollen, red, warm and hurts a little. Most pilonidal cysts form on the tailbone. Typically, this procedure is performed as a same-day surgery, with the patient discharged following the procedure. American Society of Colon and Rectal Surgeons [online]. We avoid using tertiary references. This common type of cyst is located in the crease of the buttocks and is usually caused by a skin infection. Brook I. Microbiology of infected pilonidal sinuses. Wordfence is a security plugin installed on over 4 million WordPress sites. Your message has been successfully sent to your colleague. endobj Unfortunately the area involved is sensitive. If it's red swelling and warm id get it looked at to be sure it isn't infected cuz I thought besides a foul smelling drainage those were the top symptoms. Any 3 of the STONEES criteria would be an indication to treat deep infection with systemic (oral or parenteral) antimicrobial agents. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Many patients with PSW are young and do not have the same perspective on illness, morbidity, and mortality as do more mature individuals. I had surgery done to remove my Pilonidal cyst about 4 months ago, after having several flare ups within the 4 months prior. Apply research-based information to educating patients about self-care for pilonidal sinus wounds. Other tips: A complete cure is possible, but remember that a pilonidal cyst may recur even if you had one surgically removed. Minor bleeding of various degree is expected at this stage of healing. Adv Skin Wound Care 2002; 15: 7984. World Health Organization. Unfortunately, pilonidal cysts do come back after surgery. now it bleeds almost daily? The authors review of commonly observed mistakes, and rationale for diagnosis and treatment from the literature review, observations, and practical applications of knowledge from the authors will enhance the clinicians approach to PSW management. It looks like a large pimple at the bottom of your tailbone. For any Information about our Locations, Doctors or Treatments. 31. Sitz baths or tub bath may be ordered by the physician. Sndenaa K, Nesvik I, Andersen E, Nata O, Soreide JA. a systemic infection that spreads through the body, keeping the area free of hair by shaving or using depilatory creams. These cysts develop when a pilonidal sinus fills with fluid, pus, and other debris. Pain can be managed with gentle wound care and preparation of the patient along with local dressings to minimize pain at dressing change. Youre also more likely to get one of these cysts if you have thick, stiff body hair. J Clin Pathol [online]. Pilonidal sinus wounds occur in a ratio of 4 men to 1 woman. Here are some options: Incision and drainage: This is the preferred method for a first pilonidal cyst. Its usually done in an operating room with a specially trained surgeon.'. Also, I got my son something called a coccyx cushion. Your doctor makes a cut into the cyst and drains it. A . 18. Heart failure: Could a low sodium diet sometimes do more harm than good? The patient agreed to limit his activities that would stress the wound and to alter his diet to include foods rich in protein. Pilonidal cyst excision is a type of surgery. APMIS 1995; 103: 26772. what can i do? A clinical investigation into the relationship between increased periwound skin temperature and local wound infection in patients with chronic leg ulcers. It may not display this or other websites correctly. Best Hospital For Fistula Treatment In Bangalore? Data is temporarily unavailable. Healing of pilonidal sinus wounds (PSWs) by secondary intention requires an average of 2 to 6 months, but delayed healing may require . Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. Its harder to remove the entire cyst with this method. If your incision is left open, it may take from a few weeks to several months to heal. World J Surg 1983; 7: 6415. If your incision is left open, it may take from a few weeks to several months to heal. A pilonidal sinus tunnels under the skin often with more than 1 tract or direction.2 Pilonidal sinus wound is a chronic acquired condition caused by 1 or more factors as listed in Table 1.36. I Just Had a Wide Excision!, to see what your options are. Keep the area above your buttocks clean, dry, and free from hair. It can cause severe pain and often becomes, A mucous cyst develops when the mouths salivary glands become plugged with mucus. They occur when pilonidal sinuses, small holes in the skin, become infected. A pilonidal sinus (PNS) is a small hole or tunnel in the skin. Friction and pressure from rubbed skin, tight clothing, cycling or long periods of sitting can force hair into the skin. Low-profile, bordered adhesive dressings keep the buttocks separate, reduce friction, and eliminate a nidus for pressure. The most reliable way to remove a cyst is to have your doctor do it. Plus in college I do sit a ton in classes. World Wide Wounds [online]. Thank you Hound for welcoming. Individuals are instructed to. Follow the doctors post-surgical instructions carefully. Get new journal Tables of Contents sent right to your email inbox, http://www.pilonidal.org/education/whatisit.php, www.worldwidewounds.com/2003/december/Miller/Pilonidal-sinus.html, http://www.fascrs.org/physicians/education/core_subjects/2000/fistula_in_ano, www.pilonidal.org/pdfs/bascom_1990_ps.pdf, http://www.bsi-global.com/en/Standards-and-Publications/About-standards/Glossary, http://www.who.int/cancer/palliative/painladder, Twelve Common Mistakes in Pilonidal Sinus Care, Articles in PubMed by Connie L. Harris, MSc, RN, ET, IIWCC, Articles in Google Scholar by Connie L. Harris, MSc, RN, ET, IIWCC, Other articles in this journal by Connie L. Harris, MSc, RN, ET, IIWCC, Pilonidal Sinus Disease: 10 Steps to Optimize Care, Decreased Pain in Patients Undergoing Pilonidal Sinus Surgery Treated with Platelet-Rich Plasma Therapy: The Role of Angiogenesis, Smart Dressings for Wound Healing: A Review, ABCDEFGHI Systematic Approach to Wound Assessment and Management, Privacy Policy (Updated December 15, 2022). Side-lying or prone positions do not adequately open the natal cleft for inspection of the wound because the individual is able to tense the gluteus muscles. Premature closure can lead to abscess. Learn more about marsupialization procedures here. I had my second surgery to deal with a sinus on April 14th. shower or cleanse area after each bowel movement. You can get a pilonidal cyst when a hair gets lodged inside your skin. The PSW protocol has provided continuity of care for this patient group with anecdotal success. People can help prevent pilonidal cysts by keeping the area around their buttocks clean and dry.