Post-op Complications Flashcards
What are immediate post op complications?
Pain
Haemorrhage
Low urine output
Basal atelectasis
How do you manage post op pain
Stepwise approach
- non-opioid +/- adjuvant
- mild opioid +/- adjuvant +/- non-opioid
- moderate opioid +/- adjuvant +/- non-opioid
What is low urine output a sign of?
Shock
Give IV fluids
What is basal atelectasis?
12 - 48h post op
Alveoli collapse
Diminished lung sounds
Management - chest physio
What are early post op complications?
Confusion N+V Fever Chest infection DVT Paralytic illeus
What causes a fever?
Fever = manifestation of cytokine release in response to stressful stimuli
Released due to tissue trauma aka surgery
What are the 5 W’s of post op fever?
Wind
- days 1-3
- respiratory source
- pneumonia, atelectasis
Water
- days 3-5
- UTI
Wound
- days 5-7
- surgical site infection
Walking
- reduces risk of DVT/PE
Wonder about drugs
- anaesthesia
What is paralytic illeus?
Disruption of normal bowel movement - deceleration/arrest in intestinal motility
> 3 days post op
Absent bowel sounds
Distension + vomiting
No flatus
Bowel rest
What are late post op complications?
Bowel obstruction
Incisional hernia
What is a surgical site infection?
Infection that occurs in a wound created by an invasive surgical procedure
Occurs <30 days
What are risk factors for surgical site infections?
Poor nutrition
Diabetes
Smoking
Length of operation
Insertion of surgical drain
Poor closure of wound
Clinical features of a surgical site infection
Occur 3-7 days post op
Spreading erythema
Localised pain
Pus/discharge from wound
Wound dehiscence
Management of surgical site infection
Removal of sutures/clips
Drain pus
Antibiotics
Clean dressing
What is an anastomatic leak?
Leak of luminal contents from a surgical join
Clinical features of an anastomatic leak
Failure to progress
Abdominal pain
Fever
