Postoperative Complications-3 术后并发症.ppt

Postoperative Complications Postoperative complications may result from the primary disease, the operation, or unrelated factors. The usual clinical signs of disease are often blurred in the postoperative period. Early detection requires repeated evaluation of the patient. Postoperative Complications - Wound Complications Hematoma: a collection of blood and clot in the wound. Almost always caused by imperfect hemostasis In patients with preexisting coagulopathies In patients who are given anticoagulants Vigorous coughing after operation Marked arterial hypertension after operation Postoperative Complications - Wound Complications Dangers of wound hematomas Elevation and discoloration of wound edge Increasing the incidence of wound infection In neck operations,they may expand rapidly and deviate the trachea,and compromise ventilation In craniotomies,they may cause intracranial hypertension, even brain hernia Postoperative Complications - Wound Complications Treatments of wound hematoma Perfect hemostasis in operation close the wound carefully Evacate the clot under sterile conditions Ligate the bleeding vessels Postoperative Complications - Wound Complications Seroma: a fluid collection in the wound other than pus or blood. They ususally locate under skin flaps They delay healing of wound They increase the risk of wound infection Postoperative Complications - Wound Complications Treatments of wound seroma Small seroma: no treatment, they may resorb Be evacuated by needle aspiration Compression dressings prevent recure If seroma persist: the wound should be explored in the operating room and the lymphatics ligated. Postoperative Complications - Wound Complications Wound Dehiscence is partial or total disruption of any or all layers of the operative wound. Usually occurs in 1-3% of abdominal surgery Rupture of all layers of the abdominal wall and extrusion of abdominal viscera is called evisceration Postoperative Complications - Wound Complic