What are some post op complications I should be aware of?

Fever

Fever is a vague symptom that can be normal and even expected after surgery; up to 90% of surgical patients have a low grade fever due to the body’s inflammatory response to injury. However, it can also be a sign of something more serious, such as atelectasis (collapse of small air sacs in the lung), urinary tract infection (especially if you had a foley catheter placed for surgery), wound infection, or blood clots.

A slight fever in the first two days after surgery is most likely nothing to be concerned about. However, if you develop other symptoms or if your fever worsens or persists, contact your doctor. The best way to deal with post-op fever is by preventing the more serious causes, as described in the following.

Atelectasis (collapse of air sacs in the lung)

Atelectasis can stem from the effects of anesthesia as well as a decrease in physical activity and shallow breathing after surgery. It can lead to pneumonia and other more serious respiratory complications. Depending on your procedure, coughing and deep breathing exercises may cause discomfort, but they play an important role in your recovery. Splinting (holding a pillow firmly against your incision) and adequate pain control can help make deep breathing less painful, especially if your surgery involved your chest or upper body.

You may also be sent home with an incentive spirometer. This is a device you’ll use to help expand your lungs thoroughly and gives a give visual representation of your breathing. Not everyone will need an incentive spirometer but everyone should practice some form of deep breathing and coughing to prevent atelectasis during recovery.

Urinary Retention or UTI

Blood Clots

Blood clots can form in the larger veins, commonly in the arms or legs; they can also break loose and travel, making them potentially life threatening. However, proper surveillance and preventive techniques can help reduce the risk. We screen every patient with a deep vein thrombosis (DVT) risk assessment tool and certain patients are required to have a pre-op ultrasound of their legs to check for existing blood clots.

There are also a number of techniques surgeons can use to help reduce the risk of clot formation, including “blood thinners” – anti-thrombotic medications given to help keep blood from clotting; the use of compression or ted hose during and after surgery; and the use of sequential compression devices that massage the calves to keep the blood from pooling.

While recent data call into question these risk reducing techniques for DVTs, the easiest and cheapest form of prevention during recovery is early ambulation. Ambulation, or walking, has several benefits besides blood clot prevention; it also helps promote deep breathing and helps with gas, bloating, and constipation. We want our patients up and walking by the evening of their surgery day, but always follow your surgeon’s instructions for activity limitations.

Written by Jennifer “Coop” Cooper MS, APRN, AGACNP-BC, Sergeant, US Army (veteran)

Click here for the original blog post written by Jennifer Cooper MS, APRN for BuildMyHealth.

The post Preventing Post Op Complications first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Like movies? Biofilm is the most important film you’ve never heard of! Biofilm is the technical name for the slime that bacteria secrete. It’s a problem in the case of breast implants and fillers. We generally worry about blatant infections from bacteria but in the case of implants and fillers, biofilm can cause problems other than a frank infection. Curious? Keep reading.

Biofilm and how it affects you

Obviously your doctor knows about the risk of infection anytime they inject a filler into your face or place a breast implant during breast augmentation. That’s why the doctor cleanses the skin with alcohol (in the case of fillers) or betadine (in the case of breast augmentation). But with billions and trillions of bacteria on the skin, it’s not always possible to get rid of 100% of the bacteria.

That doesn’t mean we just give up when it comes to cleanliness and good surgical technique. That’s still critical. We just have to understand the potential risks. Even if there are a few bacteria still present during surgery or non-injectable treatment, your body does a pretty good job neutralizing most of them. However, some bacteria can attach to the filler or implant after placement. The bacteria then secrete a slime that all together, represents biofilm.

With biofilm present, it’s harder for antibiotics to kill the bacteria with their protective slime covering. This doesn’t result in infection. In the case of fillers this can result in granulomas and nodules. In the case of breast augmentation, this can result in a thickening of the scar tissue around the implant. If the scar tissue around the implant is thick enough to distort the implant and breast, that’s capsular contracture.

So how do we reduce the risk. First let’s discuss fillers. As the image above shows, the more needle sticks into the skin to inject fillers can potentially bring more bacteria from the skin surface and into the filler. By using the blunt cannula technique, your doctor only makes one needle stick, rather than many. In other words, the treatment can be performed with one entry point rather than five or ten. You can see an example of the blunt cannula technique in the video below.

Blunt cannula technique video

In the case of breast augmentation, protecting the implant from any skin bacterial contamination is beneficial. For example, inserting the implant without the implant touching the skin or covering the nipple, and it’s bacteria hidden within the nipple milk ducts, can help. You can see an example of “nipple shields” in the video below.

Nipple shields video

To check pricing on any of these procedures from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

The post Considering breast aug or fillers? You need to know about biofilm! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.