Post operative Complications
- Types of complications
- Steps to Avoid Complications
- Surgcial Checklists To Avoid Complications
Post operative complications can range from minor, self limiting problems to major life threatening ones depending on the nature of the surgery and the organ operated upon. Complication can be due to anesthesia or surgery or a reaction to the stress of surgery itself. Some complications are general and apply to all procedures and some are specific that apply to only that procedure.
Common complications include fever, chest infection, pneumonia, wound infection, bleeding or deep vein thrombosis. Most of the complications manifests after the first few days of surgery – usually 1 to 3 days.
Immediate or delayed complication: Some of the complications may be evident soon after the operation while some may take a couple of days to show up, they may be called ‘immediate’ or ‘delayed’ according to the time of manifestation. There are also complications that may manifest only after the patient has been discharged from the hospital.
Associate Conditions that may Increase morbidity of Surgery: By and large it can be said that a healthy young individual undergoing a minor surgery for conditions such as piles or squint surgery will have a smooth recovery, devoid of any complications in the post-operative period. Whereas a person with other medical problems like high blood pressure, diabetes, asthma or heart or kidney disease runs a greater risk of experiencing post-op complications due to the illness he suffers from. The possibility of having complications is increased if the above illnesses are untreated or not under control. Thus it is very important to inform the surgeon as well as the anesthetist of the existence of any illness or allergy and so on. Previous instances of specific complications or problems during any surgery in the past will also guide the doctors in preventing and being prepared to tackle any complications.
Avoiding Complication: Recent statistics indicate that worldwide almost 234 million major surgical procedures are performed each year. This translates into 1 for every 25 people in the world. Majority of the patients who undergo the procedure get well and go home however major complications ranges from 3% to 16%, and rates of permanent disability or death range from 0.4% to 0.8%.
Co-operation from patients can help in preventing some of the complications. If planning prolonged surgery under general anaesthesia of the lungs or the upper abdomen, it is always wise to ask the patient to learn and practise breathing exercises for a few days prior to surgery. This not only helps to open up areas that maybe functioning sub-optimally but most importantly helps the patient resume normal breathing during the post-operative period and also helps overcome some of the sedative effects of anesthesia on the lungs. In most studies patients who undertook breathing exercises prior to surgery had less chances of lung infection and post-operative fever and had better surgical outcomes.
Similarly people who smoke should give up smoking at least a month prior to surgery.
Auto-transfusion: Patients who may require blood transfusion for an elective surgery should think of donating one unit of their own blood to prevent blood transfusion relate problems. This kind of donation has to be done a week or ten days prior to surgery.
Sometimes despite all the precautions a patient may develop a complication like deep vein thrombosis after surgery. However this is rare, if all necessary precautions are taken. The best way to avoid complications is to anticipate them.