Consent: Pilonidal Sinus Repair - Podcast Version 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent. Overview of Procedure Pilonidal sinuses often present acutely infected and therefore require incision and drainage. However, in patients with recurrent symptoms, elective wide excision or excision and primary closure may be undertaken to reduce recurrence. Overall it is a low-risk procedure. Many different techniques have been described; all have relatively similar peri-operative risks and, unfortunately, similarly high risks of wound breakdown and recurrence. Complications Intra-Operative Complication Description of Complication Potential Ways to Reduce Risk Haemorrhage Significant bleeding is a rare but documented occurence Anaesthetic risks Includes damage to the teeth, throat and larynx, reaction to medications, nausea and vomiting, cardiovascular and respiratory complications. Forms a part of the anaesthetist assessment before the operation Early Complication Description of Complication Potential Ways to Reduce Risk Pain The pain is likely to be minimal, the patient will likely only require simple analgesics only Infection Superficial wound infection is possible. Wound breakdown Delayed or non healing wound. This is the most common complication (10 – 20%) as these wounds are notoriously difficult to heal. Scarring Wide excision and healing by secondary intention will result in a significant scar. Blood clots DVTs and PEs are a possibility in any operation. The risk is increased in patients with a raised BMI, on the pill, recent flights, previous DVT, pregnancy, smokers, cancer and prolonged bed rest. The patient will be given anti-embolism stocking and low molecular weight heparin peri-operatively to minimise this risk as deemed appropriate. Stroke, MI, Kidney Failure, Death Although small, this is always a risk in any surgery Late Complication Description of Complication Potential Ways to Reduce Risk Recurrence Recurrence or incomplete excision of the sinus is common, reported in 25-30% of cases. Frequent questions What is a pilonidal sinus repair procedure? A pilonidal sinus repair involves surgical intervention to treat infected pilonidal sinuses, often requiring incision and drainage. For patients with recurrent issues, elective wide excision or excision with primary closure may be performed to decrease the likelihood of recurrence. What are the common complications associated with pilonidal sinus surgery? Common complications of pilonidal sinus surgery include pain, infection, wound breakdown, and scarring. Additionally, there is a risk of blood clots and, although rare, significant intra-operative complications like haemorrhage may occur. How can the risk of infection be minimised after pilonidal sinus surgery? To minimise the risk of infection following pilonidal sinus surgery, proper wound care and hygiene should be maintained. Patients may also be advised on the use of prophylactic antibiotics and close monitoring for any signs of infection. What are the chances of recurrence after pilonidal sinus repair? Recurrence of pilonidal sinuses after repair is relatively common, with rates reported between 25-30%. This can occur due to incomplete excision or the nature of the condition itself, necessitating careful surgical technique and follow-up. What measures are taken to prevent blood clots during pilonidal sinus surgery? To prevent blood clots during pilonidal sinus surgery, patients may be provided with anti-embolism stockings and low molecular weight heparin. These measures are particularly important for individuals with risk factors such as obesity or a history of DVT. Rate This Article