Dealing with Post Op Issues

What to expect During My Recovery from the Cleft Lift Procedure/Pilonidal RAF (Rotation and Advancement Flap)

Most patients experience a routine recovery which looks as follows:

Some patients, however, hit some bumps in the road which can delay their complete recovery.  So, what are these bumps?  What can go wrong and how can one handle them?  Most importantly, if you feel that something is going wrong, please reach out to Dr. Sternberg to discuss.

Wound Infection

This is a rare occurrence as you will be on an antibiotic for 2 weeks after surgery.  Some patients, however, are already infected with bacteria that may not be covered by the prescribed antibiotic.  If a wound infection develops the flap may become red, or the fluid in the drain may become cloudy.  It’s important that you contact Dr. Sternberg as your antibiotics may need to be changed.  On rare occasions this can lead to some wound separation.

Wound Separation

This problem occurs in around 10% of patients.  The following factors appear to predispose some patients to develop this problem:

If there is a wound separation, it often occurs around 2-3 weeks after surgery when the skin sutures begin to dissolve.  It may progress for a week and then stabilize. Sutures that take longer to dissolve can cause other issues so using sutures that dissolve more rapidly seems to be a better compromise.  Usually if there is some skin separation it will occur in the lower third of the incision close to the anus.  This likely happens for the following reasons:

What else can lead to wound separation:

What should do if you develop some degree of wound separation. 

1) DON’T PANIC!  Most of the time this does not threaten the eventual excellent outcome of the operation. 

2) contact Dr. Sternberg.

What can I expect if I develop some wound separation?

Once the wound separation stabilizes it should go on to heal, and this process may take 1 to 2 months.  Please touch base with Dr. Sternberg during this process and he will advise you about activity.  Often after a week or 2 you can exercise.  Applying a wound hydrogel to the wound often speeds healing.  We recommend Anacept gel which is available at many pharmacies and on Amazon.  You should shower and wash the wound well with soap.  After showering, dry the area well and apply the Anacept directly to the open wound.  Please keep a piece of folded gauze in the remaining buttock crack to promote air circulation.  You don’t need to shower twice a day but do apply the Anacept twice a day.