This blog will help you or your medical caregiver learn how to change your wound dressing after pilonidal sinus surgical procedures: (surgical excision, abscess incision, endoscopic pilonidal sinus treatment EPSiT, laser treatment SiLaC)

It requires changing your dressing daily and when gets soaked or wet.

1 - Dressing supplies:

• Hand sanitizer (70% alcohol)
• antibacterial liquid
• hand soap
• Gloves
• Garbage bag
• Adhesive remover
• water /normal saline / sterile water
• Gauze
• Alcohol swabs
• Forceps/tweezers/ Scissors
• Tape Cling
• Wound Covering

2-Set up

Choose a suitable area to change your dressing that is comfortable, with sufficient lighting, and it is away from children and pets, and put your dressing supplies there.

• Wash your hands very well with warm water then anti-bacterial liquid soap for at least 20 seconds.
• Dry your hands using paper towels.
• Return to the area you have chosen before to change dressing
• Open and arrange the garbage bag beside you to put your old dressing and garbage in.
• Open the dressing packages that you will need, but be careful not to touch the dressing set inside.
• Leave the dressings inside of the packages.

3 - Removing old dressing:

• Wear your gloves
• Carefully remove the old dressing, drop it in the garbage bag. can use an adhesive remover wipe to get the dressing off if requires.
• Remove your gloves and drop them in the garbage bag.
• Clean your hands again with hand sanitizer

4 - Shower:

Use a handheld sprayer to gently flush the inside of the wound and to direct soap, shampoo and loose hairs away from the wound.

Once you have finished your shower, gently wound dry with a clean towel.

If required, have someone shave the hair away from around your wound using a disposable razor designed for this area, with a swivel razor head (remove a 5cm wide strip extending at least 2.5cm from all wound edges).

5 - Clean the wound:

• Return to the site you have chosen to change your dressing at.
• Wear on a new pair of gloves
• Cleaning wound with at least 100mL (at room temperature), normal saline or sterile water.
• Your physician will instruct you to either:
• Apply the solution using a prefilled bottle or apply the solution using a 30mL syringe and wound irrigating tip.
• Gently dry the skin around the wound using medical gauze
• Sterilize the skin extending about 5cm around the wound with 0.5% chlorhexidine.
• leaving the solution in place for one minute.
• Allow the solution to air dry
• Apply a barrier wipe to the skin around the wound (not the skin you sterilized with chlorhexidine though) and allow the skin to air dry
• Clean your forceps and scissors well with alcohol swabs and allow them to air dry.
• Using the forceps, grasp the wound filler (Iodoform) dressing and cut off the amount you need to fill the wound.
• Remove this piece from the dressing package.
• Still holding the wound filler dressing with your forceps, smoothly fill the wound with the cut piece of wound filler dressing.
• Do not fill the wound tight, rather think ‘fluffy like a cloud’, while making sure to touch all edges of the wound with dressing product.

6 - Cover the wound:

• Cover the wound filler with the wound covering dressing as instructed by your physician.
• If instructed by your physician, tape the dressing in (be careful to not stretch the tape when putting it on or you may cause your skin to blister).
• Remove your gloves and drop them in the garbage bag
• Again, clean your hands with hand sanitizer.

7 - Clean up:

• If you have any leftover wound filler, place it in a sterile container using sterile forceps.
• Close the container and write the date and the name of the dressing on the container.
• In future dressing changes, access the remaining dressing pieces from the container using the forceps.
• Kindly throw the container and any remaining dressing pieces out after fourteen days.
• It is very important to store all of your dressing set in a container with a lid.
• Put the container in a clean, dry, safe place, away from the reach of children and pets, like the shelf in a closet.

8 - Call your physician:

Call your doctor or nurse if:

• wound drainage increases or becomes thick, green or dark yellow
• new or changed wound odor
• new or worsening wound pain
• wound base develops new black areas/tissue
• wound becomes bigger or new wounds appear around the main one
• tissue around the wound appears swollen, red, warm and hard to touch
• fever more than 38°C.

Finally, these instructions may be modified based on your physician recommendations.