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

Mohannad W Awwad¹, Rohail Mumtaz², Omar Al Sultan³

¹Medical Student, College of Medicine, King Saud University, Riyadh, 12372, Saudi Arabia. mwawwad2003@gmail.com.

BMC Musculoskeletal Disorders

|March 7, 2025

Summary

A novel peri-operative protocol significantly reduced surgical site infections after coccygectomy (tailbone removal) to 0%. This enhanced approach also provided substantial pain relief for patients suffering from coccydynia.

Keywords:

Coccygectomy Coccygodynia Novel surgical technique Orthopedic surgery Pain management Retrospective study Surgical site infection

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Area of Science:

Surgical Innovation
Infection Control
Pain Management

Background:

Coccygectomy is the standard treatment for coccydynia unresponsive to conservative care.
Postoperative wound infection is a significant complication following coccygectomy.
Existing treatments have challenges in preventing surgical site infections.

Purpose of the Study:

To introduce and evaluate a novel peri-operative protocol to minimize surgical site infection (SSI) risk after coccygectomy.
To assess the efficacy of the protocol in improving patient pain outcomes.
To reduce the incidence of postoperative wound complications.

Main Methods:

Retrospective review of 21 patients undergoing coccygectomy for refractory coccydynia.
Implementation of a novel protocol including pre-operative dietary changes, polyethylene glycol enema, and prophylactic antibiotics.
Post-operative adherence to strict hygiene and antibiotic regimens.

Main Results:

The novel protocol achieved a 0.0% incidence of surgical site infection.
One patient experienced delayed wound healing, successfully treated with silver-impregnated dressings.
Significant reduction in pain scores was observed before and after surgery.

Conclusions:

The enhanced peri-operative protocol effectively prevents post-operative infections in coccygectomy patients.
The protocol facilitates significant pain relief, contributing to better surgical outcomes.
This approach may establish a new standard for coccygectomy care, warranting further prospective investigation.