General post-operative complications
Post-operative complications may either be general or specific to the type of surgery undertaken, and should be managed with the patient's history in mind. Common general post-operative complications include post-operative fever, atelectasis, wound infection, embolism and deep vein thrombosis.The highest incidence of post-operative complications is between 1 and 3 days after the operation. However, specific complications occur in the following distinct temporal patterns: early post-operative, several days after the operation, throughout the post-operative period, and in the late post-operative period.

    * Immediate:
          o Primary haemorrhage: either starting during surgery or following post-operative increase in blood pressure - replace blood loss and may require return to theatre to re-explore wound.
          o Basal atelectasis: minor lung collapse.
          o Shock: blood loss, acute myocardial infarction, pulmonary embolism or septicaemia.
          o Low urine output: inadequate fluid replacement intra- and post-operatively.
    * Early:
          o Acute confusion: exclude dehydration and sepsis
          o Nausea and vomiting: analgesia or anaesthetic-related; paralytic ileus
          o Fever (see below)
          o Secondary haemorrhage: often as a result of infection
          o Pneumonia
          o Wound or anastomosis dehiscence
          o Deep vein thrombosis (DVT)
          o Acute urinary retention
          o Urinary tract infection (UTI)
          o Post-operative wound infection
          o Bowel obstruction due to fibrinous adhesions
          o Paralytic Ileus
    * Late:
          o Bowel obstruction due to fibrous adhesions
          o Incisional hernia
          o Persistent sinus
          o Recurrence of reason for surgery, e.g. malignancy


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