Fat liquefaction is one of the main reasons for poor healing of surgical wounds. Pregnant women will pay great attention to the recovery of wounds after cesarean section. Sometimes, despite extra care, the surgical wound will not heal, which may be caused by fat liquefaction or complicated infection.
What is fat liquefaction?
In general, a few days after cesarean section (more than 5~7 days after cesarean section), some surgical wounds have light yellow exudate and no special smell. The tissue around the surgical wound is slightly red in color, and the surface is cystic and sexy. Most parturients have no obvious conscious pain, and may have slight tenderness, but it is not obvious. If the surgical wound is squeezed locally, more exudate (not pus) will flow out, and floating fat drops can be seen in the exudate. Because fat liquefaction is the process of aseptic degeneration and necrosis of fat cells, exudate culture is aseptic growth, which is called fat liquefaction.
Second, the difference between fat liquefaction and surgical wound infection?
Surgical wound infection is an inflammatory phenomenon caused by bacterial infection during surgery. The surgical wound is red, swollen, painful and induration, often accompanied by obvious tenderness. If the inflammation develops further, the surgical wound will form an abscess, and a large amount of yellow or yellow-green pus will flow out after rupture. Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa are common in bacterial culture, and surgical wound infection often penetrates into deep tissue to form sinus, which makes surgical wound difficult to heal.
What are the consequences of fat liquefaction?
After fat liquefaction occurs, if it is not handled properly, bacteria will enter, which may cause secondary bacterial infection in local surgical wounds. Surgical wound infection has the risk of further development and aggravation, which will delay the healing of surgical wounds and increase the pain and economic burden of patients.
What are the four main reasons for fat liquefaction?
1. Obesity. Fat liquefaction in surgical wounds is more common in obese patients, and the blood supply of adipose tissue itself may be poor, and the blood supply may be further reduced due to the trauma to local blood vessels caused by surgery. Fat cells are necrotic due to insufficient blood supply, and then liquefied, which makes the surgical wound ooze and causes aseptic inflammation.
2. Use electrosurgical excision procedure. When electrosurgical resection is used, the high temperature generated by electrosurgical resection may lead to superficial burns of subcutaneous adipose tissue and degeneration of some adipose cells due to thermal injury. At the same time, the capillaries in adipose tissue are embolized due to coagulation, which further hinders the blood supply of hypertrophic adipose tissue with poor blood supply, resulting in aseptic necrosis of adipose tissue after operation.
3. Operation is not perfect. During the operation, the doctor's suture of fat layer is not perfect, there is dead space during suture, or there is more friction in local fat tissue, which also increases the risk of fat liquefaction.
4. Complications of pregnancy. For example, pregnant mothers with diabetes, hypertension and arteriosclerosis during pregnancy have poor tissue resistance and healing ability due to poor circulation of nerve endings, which is also one of the reasons for fat liquefaction in surgical wounds.
5. Abdominal wall thickness. Clinically, it is found that fat liquefaction is more likely to occur when the abdominal wall of pregnant women is thicker.
Third, how to deal with the fat liquefaction of surgical wounds?
If some parturients have fat liquefaction in surgical wounds, generally, they only need to cut 1 ~ 2 suture, open a few surgical wounds, put physiological saline gauze for drainage, and make the surgical wounds heal through daily dressing change. It is particularly noteworthy that in this case, all surgical wounds should not be easily opened to avoid prolonging the healing time of surgical wounds. When the surgical wound is cleaned, butterfly-shaped adhesive tape can be used to pull the skin surfaces together. Most parturients can completely heal their surgical wounds after 5 to 7 days.
If the parturient's fat liquefaction operation wound is large and exudation is more, the operation wound should be fully opened, and the normal saline gauze should be used for wet dressing and drainage, and the second-stage suture should be performed after the fresh granulation tissue grows, so as to shorten the healing time. For pregnant women with large liquefaction range and exudation, antibiotics should be used reasonably according to the doctor's advice to prevent surgical wound infection. It is also suggested that traditional Chinese medicine should be added to the dressing change to promote the healing of surgical wounds.
In addition, attention must be paid to aseptic operation during dressing change, and it is also very important to avoid bacterial infection.
Pregnant mothers stay away from fat liquefaction 3 attention?
Pay attention to diet and control weight during pregnancy.
Fat liquefaction mostly occurs in pregnant women with thick abdominal wall after cesarean section. Therefore, it is suggested that pregnant women who are overweight or obese before pregnancy should strictly control their weight during pregnancy in order to reduce pregnancy-related complications caused by obesity, such as hypertensive disorder complicating pregnancy, fat liquefaction and surgical wound infection caused by thrombosis. ?
With the improvement of living standards, pregnant women should have a certain diet control and exercise properly, and their weight should not be excessively increased. Generally, during the whole pregnancy, people with medium height will gain 12.5kg, those who are thin will gain 15kg, and those who are overweight or obese should not gain more than 10kg. In this way, pregnant women will not gain too much weight and increase the risk of fat liquefaction in surgical wounds.
Prenatal attention to correct pregnancy complications
For pregnant women with obesity, diabetes, anemia and hypoproteinemia, if they are going to terminate their pregnancy by cesarean section, they need to correct their own diseases as much as possible before operation to reduce the possibility of fat liquefaction in surgical wounds.
postpartum care
Maternal women and their families should strengthen nursing after cesarean section. Many hospitals are discharged on the fifth day after operation. After returning home, the parturient should pay close attention to whether there is exudate in the surgical wound. Once you find any abnormality, you should seek medical attention in time to prevent the surgical wound from being infected on the basis of liquefaction. The surgical wound should be treated in time to heal faster.