A comprehensive peri-operative protocol to decrease the risk of infection post coccygectomy: a case series study.

Abstract

Background: Coccygectomy is the definitive treatment of coccygodynia refractory to conservative therapy, but post operative wound infection poses a significant challenge in these patients. We introduce a novel peri-operative technique incorporating a specific pre-operatively dietary regimen, polyethylene glycol enema, and prophylactic antibiotics. Post-operatively, patients adhered to strict hygienic protocols in addition to receiving antibiotics. This technique successfully reduced the incidence of surgical site infection post coccygectomy to a rate of 0.0%.

Methods: A retrospective review was conducted on 21 patients who underwent partial or complete coccygectomy for coccygodynia refractory to 6 months of conservative therapy. Patients were treated using our novel protocol to minimize the infection risk and significant improvement in their pain.

Results: All of the patients experienced uneventful post operative recovery except for 1 solitary case of delayed wound healing. This case was treated with a silver impregnated dressing and demonstrated full wound recovery 1 week later. Additionally, pain scores showed a significant reduction of pain before and after surgery. These results highlight the efficacy of our enhanced peri-operative protocol in preventing surgical site infection as well as substantial pain relief.

Conclusion: Our findings are consistent with the existing literature, demonstrating that an enhanced peri-operative protocol not only effectively prevents post-operative infections but also facilitates significant pain relief in patients undergoing coccygectomy. This novel peri-operative protocol may offer a new standard for managing post-surgical outcomes in coccygectomy, though prospective studies are needed to further validate these results.