Diagnosis

For swelling after surgery, a diagnosis is often not absolutely necessary. Mostly it is a normal post-operative complication, which is caused by the fact that the patient does not use his leg muscles very much and therefore edema formation occurs. 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 due to swelling after the operation.

However, if there is additional pain, redness or pustular formation of the skin, unilateral leg swelling or if the swelling still exists after 2 weeks after the operation, the patient should consult a doctor. In this case, it may be a lymphatic flow disorder, leg vein thrombosis (see: Recognizing thrombosis) or an allergic reaction (see: Allergy symptoms). In these special cases an exact diagnosis of the swelling after the leg surgery is necessary.

For this purpose the doctor will have a conversation with the patient and perform a physical examination. In some cases, an examination using ultrasound (duplex sonography) can be helpful. A blood test can also be helpful in diagnosing the postoperative swelling.

The treatment of swelling after surgery depends on the cause of the swelling. Usually swelling occurs when the patient has been immobile for a long time. In this case, fluid accumulation in the skin and fatty tissue (edema formation) in the area of the lower legs is particularly common.

This is a normal process that usually does not require 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 most important treatment for swelling of the legs after surgery is therefore that the patient quickly gets fit again and tries to move the legs with the help of guided physiotherapy.

For older patients, compression stockings can be helpful as a treatment for swelling after surgery. Cooling compresses or calf wraps can also help to reduce post-operative swelling in the leg area. Elevating the leg can also be helpful.

In general, after an operation, the patient should try to keep the leg in an upright position, even after a stay in hospital, and to keep tensing the leg muscles briefly and gently. This activates the muscle pumps and promotes venous return flow from the leg to the heart. If swelling occurs due to lymph node removal, for example in the breast area, special arm positioning can help as a treatment for swelling after surgery.

Since in this case the lymph drainage is disturbed, a cushion placed between the armpits can help to minimize the swelling. In this case, however, patients should follow precise instructions from their nurses to ensure that the arm is positioned correctly. The treatment of swelling after surgery can also be done by manual lymph drainage.

This is a physical therapy. With the help of specific hand movements and pressure on the corresponding lymph drainage area, the aim is to ensure that the lymph fluid is removed more easily and in a better state. Lymphatic drainage is mainly used as a treatment for swelling after breast surgery.

It should be carried out by an experienced physiotherapist to avoid possible deterioration. It is particularly important that the lymph vessels are drained from areas far from the heart towards vessels near the heart. If treated correctly, swelling after surgery can be treated very well by means of lymph drainage.

If a swelling occurs postoperatively due to a leg vein thrombosis or an allergic reaction, the treatment is much more specific. The allergic reaction often has to be treated with medication. In the case of leg vein thrombosis, the thrombus, i.e. the blood clot, often has to be removed in a minor operation.

After facial surgery, swelling can occur in the area of the operation. This is completely normal and no cause for concern. In addition, bruising (haematomas) can also occur in the area of the face.

It is important for the patient to know that the symptoms may worsen in the first 3 days after the operation.The swelling usually increases somewhat, and the bruises also change color and become green-yellowish. However, this is the normal healing process and should not unsettle the patient. After about a week, the swelling and the discoloration caused by the bruises can be expected to subside.

In order to reduce the swelling in the face after the surgery, it is advisable that the patient positions his head as high as possible so that the fluid in the face can drain more easily towards the heart. In the hospital, the height of the headboard of the bed can be adjusted upwards by about 45° for this purpose. Furthermore, the patient can try to reduce the swelling in the face after the operation by using cooling compresses.

After some operations a so-called cooling mask is used, which the patient can put on the face. This cooling mask can be worn for 24 hours and ensures that the swelling in the face after the operation is effectively reduced. Swelling after surgery on the ankle joint occurs frequently.

The reason for this is that the patient can no longer move the ankle joint properly and therefore the fluid is absorbed into the area of the lower leg. This is a normal process, which is particularly noticeable in older patients, as the venous valves are often additionally damaged in this area. As long as this swelling at the ankle joint does not last longer than 2 weeks after the operation (post-operatively) and is not painful or accompanied by severe redness, the patient does not need to worry.

In order to reduce the swelling, it is important to discuss with a physiotherapist at an early stage when the ankle and lower leg may be put under weight again. Various muscle exercises in bed and early gait training ensure that the postoperative swelling quickly disappears again. In addition, it helps if the patient elevates the affected joint so that the venous blood return and thus the removal of fluid is promoted.

The more often the patient elevates the leg, the less swelling will be present at the ankle joint after surgery. As a rule of thumb, the patient can remember that the ankle should be positioned higher than the heart to allow the blood to flow back efficiently. Pineapple juice also seems to have a positive decongestant effect, which is why the increased consumption of pineapple juice can help to reduce the swelling in the ankle joint after the operation.

A cooling compress also reduces the swelling as well as the pain in the area of the ankle joint. However, it is important that the patient also considers the swelling as a warning sign. Especially in case of overstrain, a renewed swelling of the ankle joint can occur.

In this case it is important to allow the joint sufficient rest with the foot in an elevated position. Overall, even after half a year, it is still possible that a slight swelling can be seen on the ankle joint after the operation. It is important that the patient takes care to stabilize the ankle joint with an elastic bandage and not to wear too tight shoes in order not to cause additional swelling.

Knee swelling 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 limited in the mobility of the operated leg. As a result, blood and lymph fluid can no longer be adequately transported from the leg to the heart.

This leads to swelling in the area of the lower leg and foot after the knee operation. To minimize this swelling, it is helpful to elevate the operated leg. It is important that the leg is positioned above the heart level.

This means that the upper body should be positioned lower than the leg. Additionally, cool packs or cooling compresses can reduce the swelling after knee surgery. Furthermore, decongestant medication can be used to ensure that the swelling is reduced to a minimum.

It is important to strike a balance between sufficient muscle activation for the return transport of the fluid and sufficient protection of the joint. Various exercises should be performed with a physiotherapist to reduce swelling after knee surgery. The patient should be prepared for the postoperative swelling to persist for about one to two weeks.

In older patients with poorly functioning venous valves, slight swelling may still occur after 6 months of exercise.Here it is important that the patient pays attention to suitable footwear. Tight laced shoes as well as shoes that do not provide sufficient support (high heels, etc.) increase the swelling after knee surgery and should therefore be avoided at all costs.

Swelling after abdominal surgery is quite common and should not worry the patient. Especially in the case of a so-called laparoscopic (minimally invasive) procedure, a longer postoperative swelling occurs. The reason for this is that gas is pumped into the abdominal cavity during the operation, causing the abdominal wall to rise and giving the surgeon a better view of the organs.

The gas should have been completely absorbed by the intestine after about 1 week, so that the swelling will decrease significantly after one week. Nevertheless, it is possible that the swelling will remain longer after abdominal surgery. One of the reasons for this is that the operation causes injuries to the abdominal cavity and the abdominal muscles.

The body reacts to this with swelling, especially in the area of the scar. Especially during open surgery, this causes a swelling, which is called edema. A seroma, i.e. an accumulation of fluid in the area of the scar, also frequently occurs during major abdominal surgery.

In order to minimize this swelling after abdominal surgery, it is important that the patient does not put excessive strain on the abdomen after the operation. With the help of an abdominal bandage or an elastic abdominal bandage, an attempt can be made to minimize the postoperative swelling. Cooling compresses or cool packs can also help to keep swelling down after abdominal surgery.

If the swelling after abdominal surgery is a localized swelling only in the area of the scar, which also becomes quite hard, it can also be a scar hernia. In this case, intestinal loops pass through the damaged musculature and can then be felt on the surface as a bulge or swelling. If the swelling is rather hard and easy to localize after abdominal surgery, the patient should see a doctor again to assess the swelling.