Post-op swelling

definition

Post-op swelling is often a normal complication that can persist for up to 2 weeks after the operation. Usually this swelling is not painful after the operation and can be easily pushed away by applying light pressure on the relevant area. This is what is known as tissue edema, i.e. fluid in the skin and fat tissue. Edema always occurs when the lymphatic drainage is not sufficiently active to evacuate the fluid. This is often the case, especially after major operations, such as fractures in the thigh or lower leg.

Read more about this under: Swelling - what's behind it?

Post-operative swelling in the area of ​​the operation site is normal and occurs because the patient is barely allowed to move the operated area (mostly the leg in particular). This will make the lymphatic Drain as well as the venous Severely restricted blood flow. This can result in postoperative swelling, which is harmless as long as it meets certain criteria.

However, if the swelling does not occur in the area of ​​the operation, but e.g. in the area of ​​the abdomen, this could have another cause. A swelling in the abdomen could be a build-up of fluid in the abdomen (ascites).

Furthermore, the swelling should be accompanied by no pain. If there is pain in the area of ​​the swelling or redness or pustules on the skin, it may be an allergic reaction, for example against the plaster material (see: Rash Allergy).

By definition, swelling after surgery is harmless as long as it is

• lets himself be pushed away
• lasts a maximum of 2 weeks,
• does not grow steadily
• is not painful
• leads to no skin changes and
• may be directly related to the operation.

If these criteria do not apply, it is important to inform a specialist doctor in good time so that no lasting damage occurs.

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causes

The causes of swelling after the operation are usually very easy to determine. After many operations, especially In the case of a fracture in the leg area, the patient should hardly put any strain on the surgical wound. This is why many patients spend a certain amount of time in bed after the operation (postoperatively). Thereby are the venous blood return as well as the lymphatic drainage disturbed. Normally, the contraction of the leg muscles while walking promotes the return of the lymphatic fluid, which is also known as the "muscle pump". It collects increased fluid in the Skin and adipose tissue. This is known as Fluid edema. Especially with elderly patients postoperative swelling occurs particularly quickly. However, this cause of swelling after surgery is complete normal and harmless, however, it should disappear again within 2 weeks.

However, it may also be that the swelling after the operation has another cause. For example, it can be a patient allergic reacts to the plaster of paris or the patch. This can also lead to swelling after the operation, which is often additional itch. Furthermore, the skin is often reddened, in some cases are also found Pustules (see: Allergy rash).

Another cause of post-op swelling can be the Lymph drainage were injured by the operation (for example, lymph node removal) or by previous trauma. This can lead to a so-called Lymphocele to lead. This cause of swelling after an operation occurs mainly in operations where Lymph nodes removed were. This is for example one Breast tumor (Breast cancer) the case. The lymph drainage can no longer adequately remove the accumulating lymph fluid. There is a back pressure and thus a postoperative swelling.

A dangerous cause of swelling after surgery is deep Leg vein thrombosis. This occurs mainly in patients who have had surgery lay in bed for a long time. This phase of immobility can lead to the venous blood in the leg flows slower and slower and it becomes one thrombosis comes. In addition to the swelling after the operation in one leg, there is also a slight one bluish discoloration the skin and to one Tenderness in the area of ​​the leg, a doctor should be contacted. A leg vein thrombosis is a dreaded cause of swelling after the operation, since in the worst case it can become acute Pulmonary embolism can lead. That is why the patient should especially at unilateral leg swelling Inform a doctor in good time (see: Recognizing pulmonary embolism).

diagnosis

A diagnosis is often not absolutely necessary for swelling after an operation. Mostly it is a normal postoperative complication, which arises from the fact that the patient does not use his leg muscles very much and thus edema develops. Since this swelling is completely normal in the first 2 weeks, the patient does not necessarily need to see a doctor to confirm the diagnosis because of the swelling after the operation.

However, if there is also pain, reddening or pustulation of the skin, unilateral leg swelling, or if the swelling persists 2 weeks after the operation, the patient should consult a doctor. In this case, it can be a lymphatic drainage disorder, a leg vein thrombosis (see: Detecting Thrombosis) or an allergic reaction (see: Allergy Symptoms).

In these special cases, an accurate diagnosis of the swelling on the leg after surgery is necessary. To do this, the doctor will have a conversation with the patient and perform a physical exam. In some cases, an examination using ultrasound (duplex sonography) can be helpful. A blood test can also help diagnose postoperative swelling.

Read more on the topic: Doppler sonography

treatment

Treatment of swelling after surgery depends on the cause of the swelling. Usually swelling occurs when the patient long immobile was. In this case, one is particularly common Fluid build-up in skin and adipose tissue (Edema formation) in the area of ​​the lower legs. This is a normal process that usually does not require any specific therapy. As soon as the patient is mobile again and can move his legs, the muscle pumps are activated and transport the fluid back towards the upper body.

The main treatment The swelling of the legs after an operation is so that the patient quickly regains their fitness and tries with the help of a guided physiotherapy Move legs. In elderly patients can Compression stockings as a supportive treatment for swelling after an operation. Also cooling compresses or Calf wrap can reduce postoperative swelling in the leg area. Also the Elevation the leg can help with this. In general, after an operation in the leg area, the patient should try to rest it again and again after the hospital stay, to raise it up and to briefly tense the leg muscles again and again. This will make the Muscle pumps activated and the venous return flow from the leg to the heart is promoted.

Is it because of a Lymph node removalswelling in the chest area, for example special arm support to help treat swelling after surgery. Since the lymphatic drainage is disturbed in this case, a pillow that is placed between the armpits can help to minimize the swelling that occurs. Here, however, patients should follow precise instructions from the caregiver so that the arm is correctly positioned.

The treatment of swelling after an operation can also be done using manual lymphatic drainage respectively. This is a physical therapy. With the help of specific movements and pressure on the corresponding lymphatic drainage area, it should be ensured that the lymphatic fluid is removed more easily and in an improved manner. Lymph drainage is mainly used as a treatment for swelling after breast operations. It should be carried out by an experienced physiotherapist to avoid possible deterioration. Above all, it is important that the lymph vessels are smeared from areas remote from the heart towards those near the heart. With the right treatment, swelling after surgery can be treated very well with lymph drainage.

Is it postoperatively due to a Leg vein thrombosis or one allergic reaction to a swelling, the treatment is much more specific. The allergic reaction often has to be treated with medication, in leg vein thrombosis the thrombus, i.e. the blood clot, often has to be removed in a small operation.

Swelling of the face

To surgical procedures on the face can it become a Swelling in the surgical area come. This is completely normal and no need to worry. In addition, you can also Bruising (Hematomas) occur in the area of ​​the face.

It is important that the patient knows that the symptoms are in the worsen first 3 days after surgery can. The swelling usually increases somewhat, and the bruises change color and turn green-yellow. However, this is the normal healing process and should not unsettle the patient. After approx. a week one can expect that the swelling and the discoloration from the bruises will decrease.

In order to reduce the swelling on the face after surgery, it is advisable that the patient take his or her Head as high as possibleso that the fluid in the face can drain more easily towards the heart. In the hospital, the Height of the headboard of the bed approx. 45 ° upwards adjusted. Furthermore, the patient can try to get through cooling compresses reduce swelling on the face after surgery. After some operations a so-called Cooling mask which the patient can put on the face. This cooling mask can Worn for 24 hours and ensures that the swelling on the face is effectively reduced after the operation.

Swelling in the ankle

Ankle swelling is common after surgery. The reason for this is that the patient can no longer move the ankle correctly and the fluid sinks into the area of ​​the lower leg. This is a normal process, which is especially noticeable in older patients, as the venous valves are often additionally damaged here. As long as this swelling on the ankle after the operation (postoperatively) no longer than 2 weeks persists and not painful is or with a severe redness goes hand in hand, the patient need not worry.

To reduce the swelling it is important to start with one early Physiotherapists to discuss from when the ankle and the lower leg burdened again may be. Various Muscle exercises in bed such as early gait training ensure that the postoperative swelling disappears quickly. Additionally, it helps if the patient has the affected joint elevated, so that the venous blood return flow and thus the evacuation of fluid is promoted. The more often the patient elevates the leg, the less swelling will be on the ankle after the operation. As a rule of thumb, the patient can remember that The ankle should be higher than the heart, so that the blood can flow back efficiently. Also Pineapple juice seems to have a positive decongestant effect, which is why the increased consumption of pineapple juice can ensure that the swelling in the ankle is reduced after the operation. Also a cooling wrap reduces swelling and pain in the ankle area.

However, it is important that the patient also regards the swelling as a warning sign. Especially with overload can it become a renewed swelling of the ankle. In this case it is important to give the joint adequate Rest to treat yourself with elevation of the foot. Overall, it can after a half year still be that a slight swelling can be seen on the ankle after the operation. It is important that the patient also makes sure that the ankle joint is protected by a elastic bandage to stabilize and shoes that are not too tight to wear so as not to provoke additional swelling.

Swelling of the knee

A Kneesswelling after knee surgery is completely normal, especially in the first two weeks, and should not worry the patient. Due to the operation on the knee, the patient is often restricted in the mobility of the operated leg. As a result, the blood and lymph fluid can no longer be adequately transported from the leg to the heart. This then leads to a after the knee operation swelling in the area of ​​the lower leg and foot.

In order to minimize this swelling, it is helpful to have this operated leg to elevate. It is important that the Leg above heart level lies. This means that the upper body should be positioned lower than the leg. Additionally can Cool packs or cooling compresses reduce swelling after knee surgery. Furthermore can decongestant drugs are used, which ensure that the swelling is reduced to a minimum. The important thing is the balance between adequate muscle activation for the return transport of the liquid and one adequate protection of the joint. Various exercises should be performed with a physical therapist to reduce swelling after knee surgery.

The patient should be prepared for the postoperative swelling to be approx one to two weeks will exist. Older patients with poorly functioning venous valves may still have slight swellings after 6 months when they are exerted. Here it is important that the patient is on suitable footwear respect. Tight, lace-up shoes and shoes that do not provide adequate support (high heels, etc.) increase swelling after knee surgery and must therefore be avoided at all costs.

Swelling on the abdomen

A Swelling after abdominal surgery occurs quite often and should not worry the patient. Especially with a so-called laparoscopic (minimally invasive) There is an intervention prolonged postoperative swelling. The reason for this is that during surgery Gas is pumped into the abdomen so that the abdominal wall rises and the surgeon has a better view of the organs. The gas should after about 1 week have been completely absorbed by the intestine, so that the swelling will decrease significantly after a week.

However, it is possible that swelling lasts longer after abdominal surgery. One of the reasons for this is that the operation results in injuries to the abdominal cavity and the abdominal muscles. The body reacts to this with a Swelling, especially around the scar. Especially with open surgery, swelling occurs, which is called edema referred to as. Also a Seroma, an accumulation of fluid in the area of ​​the scar, often occurs in major abdominal operations.
In order to minimize this swelling after an abdominal surgery, it is important that the patient retains the abdomen after the surgery not overly burdened. With help of a Abdominal bandage or one elastic waist band an attempt can be made to minimize the postoperative swelling. Also cooling compresses or Cool packs can help to keep the swelling down after the abdominal surgery.

Is the swelling after abdominal surgery a localized swelling only in the area of ​​the scarthat too pretty hard however, it can also be a Incisional hernia act. Step here Intestinal loops through the damaged muscles and are then palpable on the surface as a bulge or swelling. If the swelling after the abdominal surgery is rather hard and easy to locate, the patient should consult a doctor again so that he can assess the swelling.

Homeopathy for swelling after surgery

Treating swelling with homeopathy after surgery is primarily a supportive measure. Depending on the type of swelling, different globules are used, which is why advice from a pharmacy or a knowledgeable doctor is advisable.

In the event of pressure-sensitive, bluish swelling after an operation, globules such as arnica are prescribed, usually in a D12 potency. Here about 5 globules should be taken 3 times a day. Arnica is particularly popular with swelling after dental surgery, as it can also minimize inflammation.
In the case of an operation performed close to the bone or a joint (for example the knee joint), homeopathy can also reduce the swelling after the operation. The remedy Ruta should be used here, which should be taken 3 times a day in the potency D12 for 5 days.
The Globuli Ledum, which should also be used 3 times a day for 5 days in a D12 potency, can be helpful for larger swellings.

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