Definition
Swelling after surgery is often a normal complication that can last up to 2 weeks after surgery. Normally, this swelling is not painful after surgery and can be easily removed by applying light pressure on the affected area. These are so-called tissue edema, i.e. fluid in the skin and fatty tissue.
Edema always occurs when the lymphatic drainage is not sufficiently active to remove the fluid. This is often the case, especially after major operations, such as in the case of fractures of the thigh or lower leg. Swelling in the area of the surgical site after the operation is normal and is caused by the fact that the patient is hardly allowed to move the operated area (usually mainly the leg).
This severely restricts lymphatic drainage and venous blood flow. This can result in post-operative swelling, which is harmless as long as it meets a few criteria. However, if the swelling does not occur in the area of the surgical site, but rather, for example, in the area of the abdomen, this could have a different cause.
Swelling of the abdomen could be caused by an accumulation of fluid in the abdomen (ascites). Furthermore, the swelling should be painless. If there is pain in the area of the swelling or redness or pustules on the skin, it could be an allergic reaction, for example to the plaster material (see: skin rash allergy).
By definition, swelling after surgery is harmless, as long as they do not meet these criteria. If these criteria do not apply, it is important to inform a specialist doctor in good time so that no lasting damage occurs.
- To be pushed away,
- Maximum 2 weeks,
- Not growing steadily,
- Is not painful,
- Does not lead to skin changes and
- May be directly related to the operation.
Causes
The causes of swelling after surgery 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 operation wound. Therefore, many patients spend some time in bed after the operation (post-operatively).
As a result, the venous blood return flow and the lymphatic drainage are disturbed. Normally, the contraction of the leg muscles when walking promotes the return transport of lymph fluid, which is also called “muscle pump”. Increased fluid accumulates in the skin and fatty tissue.
This is called fluid oedema. Postoperative swelling occurs particularly quickly, especially in older patients. This cause of swelling after surgery is completely normal and harmless, but it should disappear within 2 weeks.
However, it is also possible that the swelling after surgery has another cause. For example, a patient may be allergic to the plaster or the patch. This can also lead to swelling after the operation, which is often accompanied by itching.
Furthermore, the skin is often reddened, in some cases there are also pustules (see: skin rash due to allergy). Another cause of swelling after the operation may be that the lymphatic drainage was injured during the operation (for example during lymph node removal) or by the previous trauma. This can lead to a so-called lymphocele.
This cause of swelling after surgery occurs mainly during operations where lymph nodes have been removed. This is for example the case with a breast tumor (breast cancer). In this case, the lymph drainage can no longer sufficiently remove the lymph fluid that has accumulated.
This leads to a backlog and thus to postoperative swelling. A dangerous cause of swelling after surgery is deep vein thrombosis of the leg. This occurs mainly in patients who have been in bed for a long time after the operation.
This phase of immobility can cause the venous blood in the leg to flow more and more slowly, resulting in thrombosis. If, in addition to the swelling after the operation, there is a slight bluish discoloration of the skin in one leg and a painful pressure in the leg area, a doctor should always be consulted. Leg vein thrombosis is a dreaded cause of swelling after the operation, as in the worst case it can lead to acute pulmonary embolism.For this reason, the patient should inform a doctor in good time, especially in the case of unilateral leg swelling (see: Recognizing pulmonary embolism).
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