Necrotising Fasciitis Following Sinus Laser-Assisted Closure Treatment for Pilonidal Disease: A Case Report

Sinus Laser-Assisted Closure (SiLaC®) is a minimally invasive treatment for pilonidal disease, characterised by low reported rates of complications. This case report details a 49-year-old male who developed necrotising fasciitis following SiLaC. Within 24 hours postoperatively, the patient presented with severe pain, high fever, and cellulitis; however, crepitus was absent. Imaging revealed subcutaneous air extending up to the twelfth thoracic vertebra. Urgent surgical debridement and drainage were performed, accompanied by the initiation of broad-spectrum antibiotic therapy. Cultures subsequently identified Streptococcus dysgalactiae, allowing for targeted antibiotic management. The patient achieved a favourable recovery. To the best of our knowledge, this represents the first reported case of necrotising fasciitis as a complication of the SiLaC procedure.