What post-operative care instructions should I provide to a patient after surgical intervention for pilonidal sinus disease?

Following surgical intervention for pilonidal sinus disease, provide the patient with the following post-operative care instructions:

• Wound dressing management: Use an appropriate interactive dressing to manage the surgical wound, especially if healing by secondary intention, and avoid using Eusol, gauze, moist cotton gauze, or mercuric antiseptic solutions for wound care. Seek advice from a tissue viability nurse or wound care specialist for dressing selection if needed. Change dressings using an aseptic non-touch technique to reduce infection risk.
• Wound cleansing: Advise the patient that sterile saline should be used for wound cleansing for up to 48 hours after surgery. After 48 hours, the patient may shower safely and use tap water for wound cleansing, particularly if the wound has separated or been surgically opened to drain pus.
• Infection monitoring and management: Educate the patient to watch for signs of surgical site infection such as increased redness, heat, pain, swelling, or systemic symptoms like fever. If infection is suspected, antibiotic treatment should cover likely causative organisms, considering local resistance patterns and microbiological results.
• General wound care advice: Do not use topical antimicrobial agents for wounds healing by primary intention to reduce infection risk. Avoid wound irrigation or intracavity lavage to prevent infection. Sutures may be antimicrobial-coated to reduce infection risk, but this is a surgical decision.

These instructions aim to promote optimal wound healing, prevent infection, and support patient safety after pilonidal sinus surgery.

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