Informed Consent
The use of dermoplasty for the treatment of recurrent polyps is a very
demanding technique and an extended application of endoscopic sinus
surgery.
It is reasonable that certain complications may ensue from its application.
Our medical team is obliged to inform with honesty the patients about the
possibility of these complications.
Dermoplasty complications
- Nose bleed. Usually 7 to 10 days after the operation. It may ensue
without any obvious cause or following sneezing or physical activity.
- Cerebrospinal fluid rhinorrhea. It may happen during the operation and
if recognized it must be treated immediately. Meningitis is an extreme
complication.
- Trauma of the orbit which may result in diplopia.
- Trauma of the optic nerve with vision loss.
- Trauma of the anterior ethmoidal artery which may result in hematoma
formation and vision loss.
- Impairment or loss of smell and subsequent impairment of taste.
- Foul odor due to the insertion of the skin graft inside the nose. It usually
lasts for several months and is treated with intranasal insertion of drops
and ointment.
All these complications can be prevented to a high degree by an
experienced and cautious medical team, receiving a detailed and honest
medical history, combined with the compliance of the patient to the pre-
and post-operative instructions.
Information regarding Anaesthesia
The administration of anaesthesia today is a very safe practice, performed
by specialized and experienced doctors. It is necessary not only in order
to perform a surgical operation, but also for the optimization of
perioperative care (ie management of co-morbidities, fine tuning of
postoperative care). However, in certain rare occasions, unwanted
incidents may occur. These may be simple (such as rupturing a vein
during drip sitting) or more severe, such as the death of the patient (as
may occur in the case of an unknown, severe and irreversible allergic
reaction to an anaesthetic drug or any other agent used during the
operation or the perioperative period). Anaesthesiologists are trained in
effectively managing such events, which are usually reversed before the
patient leaves the operating theatres area. In certain cases, admitted the
patient to the Intensive Care Unit may be necessary, so that his /her life
and general well being are best restored. Some (but not all) of the most
serious adverse effects and complications during anaesthesia may include
(but are not restricted to) the following:
1. Allergic reaction(s) to the drugs or any other agent used before, during
or after the surgical operation
2. Regurgitation and aspiration of gastric contents, which may in turn
cause Adult Respiratory Distress Syndrome
3. Worsening of respiratory function, especially in patients with pre-
existing respiratory impairment
4. Lesions of the respiratory tract, ranging from simple pharyngalgia
(pain during swallowing) to the inability to ventilate and oxygenate the
brain, resulting in the death of the patient
5. Cardiac arrest
6. Worsening of cardiac function, especially in patients with pre-existing
cardiac impairment
7. Worsening of hepatic and / or renal function, especially in patients with
pre-existing impairment of these organs
8. Venous thrombosis and / or pulmonary embolism
9. Air, fat or foreign body embolism
10. Cerebrovascular incident (bleeding or thrombosis of the brain
vasculature)
11. Confusion (postoperative delirium), especially in predisposed
individuals (ie elderly patients)
12. Lesions of the oesophagus (the swallowing tract)
13. Mouth trauma (lips, teeth, tongue)
14. Electric burns, due to malfunction of the grounding appliances
15. Incidents related to malfunction or bad maintenance of the
anaesthesia machine, monitoring equipment or other appliances used
during the administration of anaesthesia
16. Falling of the patient off the operating table, resulting in his / her
injury
17. Awareness during anaesthesia (recollection of part or all of what
happened while the patient was under anaesthesia)
18. Nausea and /or vomiting
In order to manage your case safely and effectively, it is mandatory that
you communicate with your anaesthesiologist as early as possible before
your planned surgery. You should provide honest and precise information
to the questions you will be asked (see also the relevant form), and you
will also be given information regarding:
• The planned anaesthesia
• The possible alternative approaches
• The advantages and disadvantages of every option
• The specific complications related to each technique (ie damage to the
vocal cords that may have an effect on vocation)
• The estimated time of recovery from the anaesthetic
You may also request information on other matters, such as:
• When should you expect to "wake up"
• When will you be allowed to drink or eat
• When will you be able to walk
• When will you be allowed to leave the hospital
• Or you may need more information regarding the anaesthetic plan
Your anaesthesiologist works towards the provision of holistic care,
aiming at providing you with a safe, comfortable and pain- free
perioperative experience. We welcome you on board!
I have taken note and accept the above terms.
The patient The cognate
Download the full consent article here (Consent)