Hemorrhage
One of the common postoperative complications can occur after mass resection or radical resection. The causes of bleeding are often as follows: 1. Active bleeding spots are left behind due to incomplete hemostasis during operation; 2. After operation, due to the application of continuous negative pressure drainage, posture change or severe cough, the coagulation clot of electrocoagulation falls off or the ligated silk thread slips off, resulting in drainage bleeding; 3, preoperative application of chemotherapy or hormone drugs makes the wound easy to ooze blood.
hydrops
refers to the accumulation of liquid between the skin flap and the chest wall or armpit, which causes the skin flap not to cling to the wound. It is also one of the common complications after breast tumor surgery. The common reasons are as follows: 1. Poor drainage makes the exudate of the wound unable to be drawn out in time and accumulate; 2. The blood in the wound coagulates to form a blood clot, which cannot be drained out and liquefied to form effusion later; 3. When dissecting the lymphatic fat around the axillary vein, some small lymphatic vessels were damaged without ligation, accompanied by poor drainage to form hydrops, which generally occurred on the outside of the axillary vein; 4. When dissecting axillary vein with electrotome, the chances of hydrops are more than using scalpel. It may be that electrotome has a certain influence on wound healing, and some small lymphatic vessels are temporarily closed after electrotome dissection, but open again after negative pressure suction to cause hydrops; 5. The tension of this flap is too high, which makes the wound difficult to cover and the drainage tube is pulled out too early.
Skin flap necrosis
is also a common complication after breast cancer surgery. Because of the necrosis of the skin graft, the healing is delayed, which may affect the subsequent treatment. Radical mastectomy often needs to remove more skin, and the skin flap is separated in a large range, and the skin flap is peeled off too thin or unevenly, which will destroy the capillaries in the dermis and affect the blood supply of the skin flap after operation. Or the tension of the flap is too high when it is sutured, and when the wound accumulates fluid after operation, it will also cause ischemic necrosis of the flap; Sometimes due to improper operation of electrosurgical excision procedure, local skin burns or coagulation embolism of blood vessels are caused, and it is also easy to cause skin flap necrosis. Skin flap necrosis usually occurs 24 hours after operation, the ischemic skin turns pale and gradually turns blue-purple, and there are small blisters on the surface of edema < P >. After 3 ~ 7 days, the boundary of necrotic area gradually became clear, and the skin gradually showed black hard scab.
edema of upper limbs
after radical mastectomy, edema of upper limbs is easily caused due to the obstruction of lymph and blood return of upper limbs. The incidence of upper limb edema varies from 5% to 4%, and the incidence of severe upper limb edema has decreased significantly in recent years, not exceeding 5%. The causes of serious reflux disorder of upper limbs are as follows: 1. Improper axillary cleaning scope destroys local collateral circulation. In the past, when dissecting lymph fat around axillary vein, the axillary sheath was often removed at the same time, which also affected the lymphatic reflux after operation. Therefore, it is not necessary to remove the axillary vascular sheath if there is no obvious swollen lymph node during operation. In fact, if swollen lymph nodes invade the axillary sheath, it is often impossible for surgery to completely achieve the goal of radical cure; 2. There is effusion or infection in axillary region, which causes local congestion, and the formation of fibrotic scar hinders the establishment of collateral circulation; 3. Postoperative radiotherapy of supraclavicular, infraclavicular and axillary regions caused local edema, connective tissue hyperplasia, local fibrosis and then edema.
Muscle atrophy of limbs and hands
It is often caused by the injury of brachial plexus or its sheath during operation, and the atrophy of thenar muscle is common.