Complications after operations

Just as an accident can happen on any car journey, operations can be accompanied by complications. The following saying is familiar to every surgeon:

“Only the surgeon who doesn’t operate hasno complications.”

However, if they have occurred, the quality of the doctor is required to recognize them in good time and rectify them or at least minimize the damage.

General complications

The complications described in this paragraph are specifically designed for plastic surgery and hand surgery. In principle, however, they apply to all operations.

• Thrombosis and embolism are feared but rare side effects – If the blood clots, usually in the veins of the leg, this is known as thrombosis. If blood clots then enter the lungs or brain via the bloodstream, this is known as an embolism. These complications are more common in the case of severe immobilization, obesity, smokers and women taking the contraceptive pill. This complication can be greatly reduced by administering heparin injections.
• Bleeding and bruising – These should be prevented by careful hemostasis. However, a vessel can start bleeding again after the operation due to an increase in blood pressure, coughing and too much movement. A decision must then be made as to whether it can be controlled conservatively by applying pressure and immobilization or whether it should be removed surgically.
• Infection – No matter how sterile you work, germs are omnipresent, even if in small quantities – e.g. at the hair roots or sweat gland ducts. If diagnosed in good time, we can often contribute to healing with antibiotics in tablet form, infusions or ointments.
• Complications due to injury to neighboring structures
  • Nerves
  • Blood vessels
  • Organs
  • et al.
• Wound healing disorders are complications that usually occur due to impaired blood circulation. This is why they are found in corner sutures (T-cut breast reduction or T-abdominoplasty). Wound healing disorders are more common in smokers, obesity, diabetes mellitus, alcoholism and pronounced arteriosclerosis. A reduced immune defense also plays a role here.
• Restricted movement can be caused by scarring. These complications usually occur in hand surgery when the hand has to be immobilized for a very long time.
• Scars – Scarring varies greatly from person to person. One problem is so-called hypertrophic scars and their extreme form, the keloid. These changes are a predisposition with bulging scar formation, i.e. not complications in the narrower sense. With appropriate scar ointments, cortisone ointments and, if necessary, infiltration of cortisone with an injection, these scar formations can be controlled in most situations. Only rarely does a keloid develop, which sometimes even has to be treated with cryotherapy or radiation if the above measures are ineffective.
• Skin sensitivity disorders and possibly numbness can occur after an operation. A typical area, for example, is the region above the center of the scar after a tummy tuck. Here, the skin nerves have been severely affected. This discomfort often improves within 4-6 weeks. However, it can also remain.
• Recurrence – Means the recurrence of a disease or change. It is therefore not always a complication.
• Follow-up surgery – complications can make further operations necessary. In plastic surgery, a repeat operation is sometimes useful to improve aesthetics, perfect symmetry, correct scars or correct small residual skin excesses.