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Complications

It is extremely important that you know what to do in the event of a complication. In normal working hours, it is best to contact the office for advice. Out of hours, it is always possible to contact the hospital in which the treatment was performed, where a nurse or resident doctor will take down details of the problems that have arisen and will communicate these to me. Sometimes, all that is required is advice over the telephone whereas on other occasions, an early outpatient appointment or even re-admission to hospital may be the right course. There can be little doubt that patients are best cared for in the event of complications by the surgeon who performed their original procedure.

Infection occurs in approximately 3% of patients and usually evolves between the time of discharge from hospital and the date to return for the first outpatient visit. Symptoms and signs include redness, swelling, pain, fever, feeling unwell and ultimately a discharge of pus from the wound. Superficial infections can be managed by antibiotics alone but more severe infections, perhaps even the development of an abscess, may require re-hospitalisation and even additional surgery. Neglected or severe infection may spoil the results of surgery.

Delayed wound healing tends to complicate larger wounds and is usually treated by dressings and wound care

Haematoma (blood collection in the wound) occurs in 5% of cases and is an early complication, typically occurring within the first 24 hours. The treatment is to evacuate the blood collection and arrest any bleeding under local or general anaesthetic. This does not normally have any long-term consequences.

General complications may occur, including deep vein thrombosis and pulmonary embolism, (blood clots in the veins of the legs which may dislodge to the heart/lungs and may be life threatening). This risk is significantly higher in women taking oral contraceptive pills but this risk can be reduced by discontinuing the pill for six weeks prior to surgery. Some patients choose to continue taking the oral contraceptive – blood-thinning injections can then be given to mitigate the risk.