Nursing of fluid accumulation after breast cancer surgery

During the perioperative period of breast cancer surgery, inadequate preparation or improper postoperative care can easily cause postoperative subcutaneous effusion. Active treatment is necessary after subcutaneous effusion occurs so as not to affect the patient's recovery. The following will introduce the causes and postoperative care of subcutaneous effusion. The main factors that cause subcutaneous effusion in the wound after breast cancer surgery are the following four aspects:

1. Inadequate preoperative health education. Inadequate health education is caused by nurses being too busy, poor theoretical knowledge, weak sense of responsibility or poor patient compliance, which leads to patients lacking relevant knowledge after surgery and prematurely moving the affected shoulder joint. It is common for patients to use the affected upper limb to support the bed to get out of bed, or to support the affected side when support is needed, causing the wound flap to slide and affect healing, thus forming a dead cavity, producing lymph fluid, and causing subcutaneous effusion.

2. Subcutaneous blood drainage is not smooth. Due to the pressure, twisting, blockage of the drainage tube or insufficient negative pressure of the drainage bottle, the drainage is not smooth, and the exudate and bleeding form fluid and blood accumulation in the wound.

3. The tightness of the chest bandage is not appropriate. Appropriate pressure bandage has a certain auxiliary effect on flap healing, which can forcibly eliminate dead space and keep the flap and the thorax relatively fixed, effectively reduce wound exudation and microvascular bleeding, prevent exudate and hematoma, and reduce tissue edema, which is beneficial to venous return and flap survival.

4. Improper activity of the affected limb. Appropriate functional rehabilitation exercises can promote blood circulation in the affected limb, promote the discharge of metabolic products and oxygen supply, facilitate venous return and drainage of the upper limb, promote the disappearance of upper limb edema after surgery, and reduce the incidence of subcutaneous effusion, hematoma, flap necrosis and scar contracture.

Care:

Subcutaneous effusion is composed of lymph and wound exudate and blood. Through our timely and correct nursing intervention, patients and their families can understand the precautions after surgery, the importance of keeping the drainage tube unobstructed, the role of chest strap pressure bandage and the significance of timely and appropriate activities of the affected limb, so as to standardize the patient's postoperative self-protection behavior, prevent the wound surface that has initially healed after surgery from being damaged again, reduce the chance of subcutaneous dead space generation, and reduce subcutaneous effusion.

Because 6 to 8 days after surgery is the time for initial shoulder joint activity, and 12 to 14 days after surgery is the time for starting shoulder joint functional training, after we implemented correct nursing intervention in the observation group, the patients learned to protect themselves, while the patients in the control group did not move their affected limbs properly, which aggravated the production of subcutaneous effusion and prolonged the retention time of the drainage tube.

The chest bandage should be applied within 5 days after surgery. From the experimental group, it can be seen that moderate pressure bandage has a certain auxiliary effect on flap healing. It can reduce the local blood, lymph and exudate in the early postoperative period, thereby shortening the drainage tube retention time. After 14 days after surgery, the patient's wound has healed, or the cause of subcutaneous effusion is related to individual differences of the patient. At this time, the effect of nursing intervention is not as obvious as before 14 days after surgery.