In Medicine, What are Complications?

1. The latter-type disease is caused by the former type;

[bìng f zhèng]

Complications are a complex clinical medical concept. Scholars have the following definitions of complications: one refers to the occurrence of another disease or symptom in the development of a disease, the latter is a complication of the former, such as peptic ulcer may have pyloric obstruction, Complications such as gastric perforation or major bleeding. Another kind of complication is that during the diagnosis and treatment, the patient has suffered from one disease and another disease or diseases related to the disease occurred.

Three basic characteristics of complications

1. The latter-type disease is caused by the former type;

2. From the perspective of the occurrence of post-disease, there is no necessary causal relationship between pre- and post-disease diseases. Therefore, the emergence of the latter disease is sudden;

3 The emergence of the latter disease was not caused by the fault of medical personnel.

Complications of chickenpox

Generally rare, the more common varicella complications are the following.

Complications secondary bacterial infection

Including secondary rash, purulent secondary infection, cellulitis, acute lymphadenitis, erysipelas, sepsis and so on.

In recent years, it has been reported in the United States that children with chickenpox complicated with Invasive Group A streptococcus GAS, which mostly occur on the 3rd to 6th days of chickenpox. The syndrome (Streptococcal toxic shock-like syndrome ISLS) is critically ill and has a high mortality rate. Special attention must be paid to timely prevention and treatment measures.

Varicella encephalitis

Encephalitis occurs in about 1 to 1,000 cases. Mostly occurred on the 3rd to 8th days of the disease course, and a few were seen 2 weeks before or 3 weeks after the rash. The condition varies, with symptoms and cerebrospinal fluid findings similar to general viral encephalitis, with a mortality rate of 5% to 25%. Other rare neurological complications include transverse myelitis, peripheral neuritis, and optic neuritis.

Complications of primary chickenpox pneumonia

More common in adults with chickenpox and immunocompromised. Those with mild symptoms may be asymptomatic or have a dry cough, while those with severe symptoms include hemoptysis, chest pain, shortness of breath, cyanosis, and fever. Severe cases can be fatal, especially during the second and third trimesters of pregnancy. The signs are not obvious. Pneumonia symptoms are more common 2 to 6 days after the rash, and can also be seen before or 10 days after the rash. Diagnosis is mainly based on X-ray examination. X-ray diagnosis of chickenpox in adults is complicated by chickenpox pneumonia, and only 4% have pneumonia.

Complications other

Varicella and Reye syndrome often occur in the late stages of chickenpox, with vomiting, restlessness and irritation, and progress to cerebral edema. Pathological changes in the brain are related to high ammonia. Since aspirin is also considered to be associated with Reye syndrome, foreign countries believe that chickenpox infection It is best to disable aspirin for fever. Myocarditis, nephritis, arthritis, and hepatitis are rare.

Any surgical treatment is not foolproof, and there may be complications of one kind or another. But the complications are not terrible. It is important that even if complications are found and managed, people can get back to health. Breast augmentation is no exception. The following describes the complications of breast augmentation surgery and explains how to deal with them.

Complications of laser hair removal

What are the complications of laser hair removal?

1. Local swelling: It is mainly a specific reaction caused by tissue thermal vaporization, and it may also be the manifestation of infection.

2. Depigmentation: Postoperative infections and softening of scars may eventually cause discoloration.

3. Scars: It is mainly caused by allergies or scar constitutions, or postoperative infections, and excessive damage.

4. Pigmentation: What are the complications of laser hair removal? Pigmentation is also one of them. There must be a change in color after skin damage. It is pink when exfoliated, gradually transitions to dark brown, and finally fades to be consistent with the surrounding skin.

5. Skin thermal damage: Insert the depilation needle correctly, keep the insulation away from the skin, or press the switch prematurely during the insertion process, causing burns to the epidermis.

6. Sebaceous gland deficient eczema: The sebaceous glands are located near the hair shaft and the duct opening is located below the pores. When the hair is removed, the pores are occluded and the sebaceous glands are damaged to cause the disease.

7, buried hair: What are the complications of laser hair removal? Many people do not know that buried hair is one of them. The hair follicles are not completely destroyed and the pores are closed, so the regenerated mutant hairs cannot penetrate the pores smoothly and smoothly.

8, internal bleeding: pre-operative examination is not detailed, suffering from certain blood diseases, or the operation of rough needle bends, as well as violent postoperative activities can cause internal bleeding.

9. Folliculitis: It can be caused by improper epilation needles and skin disinfection before surgery, retention of postoperative contents and pore occlusion.

Complications of liposuction failure repair six major complications

First, the operator should be well aware of the blood vessel and nerve anatomy of the liposuction site, and strict and accurate liposuction procedures, so as to minimize the occurrence of surgical complications, but should be repaired as soon as possible.

Second, skin ecchymosis is mostly caused by aspiration of shallow layers of fat and bleeding, improper suction operation, such as lateral suction will damage larger nerves and blood vessels, so it must be accurately operated, if darker For blood-containing fat mixtures, the suction direction of the pipette should be changed or the suction should be suspended. At the same time, the local pressure is appropriately applied for a period of time, usually 3-5 minutes, which is implemented by the assistant.

Third, skin necrosis and blood circulation disorders are both related to skin trauma and shallow suction. Generally, the suction depth is about 2 cm under the skin.

Fourth, the infection of wounds and liposuction areas is mainly related to inadequate disinfection and the formation of hematomas in the operation area. The treatment is not timely. In addition to paying attention to liposuction methods, powerful antibiotics should be used in time. Blood transfusion and transfusion treatment should be performed at the time, but liposuction repair surgery should be done as soon as possible. An important point in the six major complications of liposuction repair.

Fifth, skin wrinkles and unevenness are related to uneven liposuction, inconsistent volume, and loose skin. Once treatment is very difficult, it is better to pay attention to operating procedures and methods, but when it appears, you should do liposuction repair as soon as possible. Is the only solution.

6. Fatty lung or cerebral embolism is a very serious and fatal complication. In addition to paying attention not to damage the large blood vessels during the operation, the operation is completed carefully, and the unabsorbed fat and liquefied fat are carefully pressed. The operation is effective. Appropriate pressure bandaging can not only reduce pain, prevent bleeding, but also help shape and smooth the skin. It can also reduce the chance of residual free fat particles entering the blood vessels, thereby reducing the occurrence of serious complications of fat embolism.

Complications surgical defect

Complications of insufficient bags under the eyes

This is also because the plastic surgeon was too conservative when designing the surgical plan before the operation, which caused insufficient fat removal during the operation, and the bags under the eyes still existed after the operation, and the effect of the operation was not ideal.

Complications ocular blood vessel injury

This is because the plastic surgeon sucks fat with a needle under blind vision when performing an incision to remove the bags under the eyes. It is more likely to damage the blood vessels. Once the blood vessels are injured, there is a possibility of affecting the eyes, vision and even blindness. So what are the complications for incision under the eyes? And those?

Orbital depression

This symptom is most likely caused by the surgeon's desire for a while or the plastic surgeon's failure to make an accurate calculation of the amount of fat removed, resulting in excessive orbital fat removal.

Complicated eyelid skin sagging

This is caused by the wrong surgical method chosen by the subject. Generally speaking, the subject with poor skin elasticity is not suitable to choose the method of eyelid removal under the eyes, which may cause The result is slack eyelid skin after surgery.

Complications of breast augmentation surgery

Complications bleeding and hematoma

Bleeding during and after breast augmentation is a more common complication and should be avoided. Surgery should not be performed during menstruation. Cells and blood clotting time should be tested before surgery to exclude the possibility of blood diseases. Vitamin K110mg / day should be applied 2 days before surgery. After the preparation of the cyst cavity during the operation, the gauze with hot saline was implanted into the cyst cavity to stop bleeding. After the operation, a negative pressure drainage was implanted in the cyst cavity.

Complications

The most common malformation after breast augmentation is the high position of the breast, which is due to the poor preparation of the breast augmentation sac cavity, especially the placement of the prosthesis and the insufficient attachment of the pectoralis major muscle and the inferior lateral pectoralis fascia. This morphology is most commonly seen in axillary incisions.

Complications of sagging breasts

This is because the breast cavity is too large and exceeds the submammary folds. Such complications mostly occur in cases where the prosthesis is under the breast, and can also occur in patients with loose breast skin and oversized prostheses.

Fibrocyst formation

Fibrocyst formation is more common after breast augmentation. Preventing multiple injuries during surgery, preventing bleeding and hematoma, preventing foreign bodies from entering the breast augmentation cavity, and preventing postoperative breast damage are effective methods to prevent and reduce cyst formation. Once the fibrous sac is formed, surgery must be performed. Fibrous capsule formation occurs more often when the prosthesis is placed under the skin. For example, patients who have implanted a prosthesis after a radical mastectomy for breast cancer are also prone to have less breast tissue. Recipients with a prosthesis implanted under the breast

Complication

It is relatively rare and the surgeon who underwent a sub-breast fold incision should remove the prosthesis once it occurs.

Complications prosthetic granuloma

It is also relatively rare. It has been seen in those who used the first domestic prosthesis. The situation can be improved after replacing the prosthesis.

Complications Prosthesis rupture or leakage

More common in domestic prostheses and imported prostheses for more than 5-10 years. Once this happens, the prosthesis must be removed, replaced, or breast augmentation terminated

Complications upper arm pain

It may be due to compression of the intercostal arm nerve. Although it is rare, it is difficult to manage, and it can be treated with physical therapy, nerve closure, etc.

Complications infection

It is very rare, but it also happened after breast augmentation in a beauty salon. Severe cases cause extensive infection of the pectoral muscle space, which can only be resolved by removing the prosthesis and debridement and drainage.

Complications pneumothorax or empyema

It is also a very rare complication. Because the surgery enters the chest cavity when the pectoral muscles are separated, it can cause complications such as pneumothorax, pneumothorax, or empyema. The preventive method is to separate the pectoral muscles under direct vision, and separate the pectoral muscles on the surface of the ribs.

How to prevent complications of breast augmentation

1. After breast augmentation, there will usually be pain and bruises in the chest, the degree of which varies from person to person, depending on the method of surgery, the nature and the physical fitness of the individual. The pain usually lasts about two to three days and can be controlled on time as directed by your doctor. Bruising will resolve in about one to two weeks.

2. After two to three days of rest, daily activities can generally resume after two to three days on the surgery day. You can work as usual after the fifth to seven days after the operation. Avoid raising your arms and carrying heavy objects in the first week after surgery. Avoid steam baths and swimming for two weeks. Vigorous exercise can only be performed two weeks after the operation.

3. There will be a simple dressing on the wound after prosthetic breast augmentation, and a bandage will be used to fix the breast. After two to three days, go to the doctor for a follow-up examination and you can bathe normally. Schedule another week for follow-up visits one and six months later. The sutures in the wound will dissolve automatically within ten days.

4. According to the doctor's instructions, in the first month after surgery, wear any of the fitting soft bust or positioning chest strap, or leave the bust to allow the breast tissue to form naturally. The breast will feel swollen and not soft at the beginning. After one to two months, the breast texture will be more natural. When you mentally integrate it into a part of your body, no longer pay attention to the existence of the prosthesis, you are fully recovered.

5. Do not wear a bust with iron wire within six months after operation to prevent the deformation of the chest and the occurrence of capsular contracture (capsular fibrosis).

6. Sexual behavior should be avoided within two weeks after breast augmentation to avoid touching the breast.

Liability and exclusion of complications

Complications imputation and exemption refer to the principle of attribution of responsibility for patients after complications occur. At present, the law of our country adopts the principle of liability for faults for medical damages, that is, medical institutions and their medical personnel only bear civil liability if there is a medical fault for the occurrence of medical damages. No fault means no liability.

Complications of medical errors

1. Whether the medical staff has fulfilled the obligation to foresee risks

Complications are generally foreseeable. For example, a fracture of the distal femur may cause iliac artery injury, anastomotic atrophy may occur after esophageal cancer resection and esophagogastric anastomosis, and thyroid surgery may damage the recurrent laryngeal nerve. If complications should be foreseen but not foreseen, it means that the medical staff failed to fulfill their obligation to foresee the results and constituted medical negligence.

2. Whether the medical staff has fulfilled the obligation of risk notification

Article 26 of the Law on Practising Physicians stipulates that physicians shall truthfully introduce the condition to patients or their families. The "Medical Accident Handling Regulations" stipulate that in medical activities, medical institutions and their medical personnel shall truthfully inform patients of their conditions, medical measures, and medical risks. If this obligation is not fulfilled, it can be determined that it violates the legal notification obligation and constitutes medical fault.

3. Whether the medical staff has fulfilled the obligation of risk avoidance

Whether the medical staff has fulfilled the obligation of risk avoidance, that is, the medical staff has taken corresponding diagnosis and treatment measures to avoid complications as much as possible. The relative avoidability of complications determines that under certain conditions, complications can be avoided to a certain extent as long as the medical staff pays sufficient attention and takes active and effective precautions. For example, in cesarean section, the surgeon should pay special attention to prevent the ureter from damaging the patient. However, it should be noted that the avoidability of complications is relative. In clinical practice, sometimes even if medical staff pays sufficient attention to the complications and takes preventive measures, it is still difficult to avoid complications. For example, if the goiter is very closely attached to peripheral nerves, it will be difficult to avoid nerve damage during resection. At this time, as long as the medical staff can prove that they strictly abide by the technical operation specifications during the operation and pay sufficient attention to the occurrence of adverse consequences, the medical staff need not bear responsibility.

4. Whether the medical staff has fulfilled their medical treatment obligations

Whether medical staff take proactive treatment measures after complications occur to prevent the damage from expanding. Taking the recurrent laryngeal nerve injury in the thyroid as an example, the recurrent laryngeal nerve injury caused by severance and suture is a permanent injury, while those caused by cramps, stretches, and hematoma compression are temporary, and undergo appropriate physical therapy. After timely processing, it can generally recover gradually within 3-6 months. Therefore, for the latter, medical personnel should take active and effective precautions to minimize the damaging consequences of complications.