Staunton M D
Phlebologie. 1982 Jan-Mar;35(1):329-35.
This paper deals with some selected complications of operation. The majority arise from technical faults and errors in judgement or documentation. My choice of topics here has been for their immediate treatment and the avoidance and aftercare of the others. Wrong technique. Combined operations resulting in damage to important adjacent structures: a) arteries: divisions, ligations, stripping; veins: ligation, tearing, avulsion of saphena femoral junction; b) nerves: division, femoral, lateral popliteal, cutaneous; c) lymphatics: particularly in recurrent operations, lymphoma and subsequent oedema; d) skin: particularly incisions through thickened skin, inflammatory skin, oedematous skin; e) connective tissues. Major complications. Haemorrhage, shock, problems with skin closure, methods of dressings, post-operative immediate, anaesthetic problems. Haemorrhage, haematoma, swelling, oedema, lymphatic deep vein thrombosis, pulmonary embolism (1 in 3000--fatal 1 in 30,000). Wound healing, skin necrosis, wound infection. Leg complications: persistent varicose veins, recurrent varicose veins, pain, nerve palsies, chronic oedema.
本文论述了一些特定的手术并发症。大多数并发症源于技术失误、判断错误或记录错误。我在此选择这些主题是考虑到它们的即时治疗以及对其他并发症的预防和术后护理。错误的技术。联合手术导致重要相邻结构受损:a) 动脉:切断、结扎、剥离;静脉:结扎、撕裂、大隐静脉股静脉交界处撕脱;b) 神经:切断、股神经、腘外侧神经、皮神经;c) 淋巴管:特别是在再次手术、淋巴瘤及随后的水肿中;d) 皮肤:特别是通过增厚皮肤、炎性皮肤、水肿皮肤的切口;e) 结缔组织。主要并发症。出血、休克、皮肤缝合问题、敷料方法、术后即刻、麻醉问题。出血、血肿、肿胀、水肿、淋巴性深静脉血栓形成、肺栓塞(3000例中有1例——30000例中有1例致死)。伤口愈合、皮肤坏死、伤口感染。腿部并发症:持续性静脉曲张、复发性静脉曲张、疼痛、神经麻痹、慢性水肿。