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Have a cyst in gluteal region. Removed by surgery. Found subcutaneous abscess with granulation tissue

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Practicing since : 2009
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Hi, I have a cyst in gluteal region. The cyst is coming repeatedly since 3 years. 2 weeks back removed it by surgery. Again it started forming. Lab reports says subcutaneous abscess with granulation tissue. Please suggest a solution.
Posted Thu, 9 May 2013 in Infections
Answered by Dr. Shoaib Khan 4 hours later
Hello and welcome to XXXXXXX

Thank you for writing to us.

Let me provide all the details of treatment of an abscess, as all the options have been used in your case, but there is a possibility that a few details might have been either overlooked or inadequately performed. So all details of the treatment are as follows:
-First of all you need to know what to do and what not to do at home.
+Apply warm compress to the region for 20-30 minutes, at least 3-4 times a day
+Please do not try to burst the region yourself or with any sharp objects
+Keep the area clean and dry; applying a sterile dressing even at home will greatly help

-Now coming to the medications:
+Antibiotics will be mandatory in your case, as you are having a recurring infection. Thus a broad spectrum antibiotic will have to be initiated before the surgical drainage
+Pain management medication
+Cleaning of the region with an antiseptic solution on a daily basis

-Incision and drainage: This is a minor surgical procedure and will have to be performed by an experienced medical practitioner or else the abscess will recur. Instructions to be kept in mind:
+Clean area with antiseptic solution
+Place sterile pads all around the site, leaving only the site of the abscess exposed
+Incise the abscess with a sterile scalpel and drain all pus and debris; some times there will be more pockets of pus at different locations which will have to be cut open separately; an experienced doctor will palpate and accurately find these (if present)
+Clean the entire cavity from inside with an antiseptic or antibacterial solution, simultaneously removing all the pus and debris (dead tissue)
+Insert sterile packing inside the cavity and close with the help of sterile bandage
+Schedule regular patient follow-up visits to monitor the response of the antibiotics and for regular change of dressing, to prevent re-infections

This is the only treatment used to treat abscesses. And if performed correctly, will never lead to re-infections. Also, I request you to kindly check your blood sugar levels, as this is one reason why infections can recur. Once the infection has been treated, maintaining good hygiene and special care of the area will be crucial.

I hope you found my response helpful and informative. Do write back to me for any further clarifications. I would be more than happy to help you.

Best wishes.
Above answer was peer-reviewed by
Follow-up: Have a cyst in gluteal region. Removed by surgery. Found subcutaneous abscess with granulation tissue 52 minutes later

1.what might be the reason for the cysts to be coming?is it a hormonal thing?or some other infection?
2.should i be meeting a colorectal surgeon this time?the surgery was performed by a plastic surgeon last time that i have had a surgery done weeks back,can i be operated again now?
4.can you refer me to any doctors whom i could XXXXXXX in Chennai regarding this problem?
Answered by Dr. Shoaib Khan 10 minutes later
Hello once again.

Let us get to your queries:
1. There could be many reasons for this sir. But, the first thing we would look into is a diabetes profile, as diabetes is one of the main reasons for poor healing and multiple infections. The next thing we would consider is improper technique used to drain the abscess.

Also, was a sample of the pus from the cavity sent to the laboratory? If yes, we would get information on the particular infection-causing organism and which medication would be most effective in treating it. This investigation is called a culture and sensitivity. Please ask for the details of the same from your doctor. If we know which medication will be most effective, we can easily treat your condition.

You could XXXXXXX a more experienced doctor who will properly drain your abscess and cancel all chances of a re-infection

2. You should XXXXXXX a general surgeon as the cyst is in the gluteal region sir. A plastic surgeon can be present along with the general surgeon only to ensure good aesthetics.

3. Only if the abscess or cavity is large enough for surgery, then you can undergo surgery again sir. Time frame does not really matter in such situations. If it is small, then initiating medication will be the only option

4. Dr. XXXXXXX R in Porur; Dr. V Ramalakshmi in Valasaravakkam; Dr. Srivatsan in XXXXXXX Nagar West, General surgeons at Apollo Hospitals in Todiarpet; or any other well-experienced General surgeon in Chennai will do.

I hope this information helps. Do write back to me for any further clarifications sir. I would be happy to help you.

Best wishes.
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