Risks

All patients should expect some post-operative swelling. The scars are relatively long and run from the elbow, along the inner aspect of the upper arm and onto the trunk. Patients can bleed in the first day after surgery and require a second operation to stop this bleeding. This is a rare event, bleeding would be suggested by unexpected pain, tightness of the wounds, and oozing into the wound dressings.

Common complications include the build up of fluid below the skin in the weeks after surgery. This can require drainage in clinic as an out-patient using a syringe

The risk of systemic complications, such as thrombosis or pulmonary embolism is minimized by the use of thrombo-embolic stockings, compression of the patients calves in theatre, injection of low-molecular weight heparin after surgery, warming in theatre and in recovery, and early mobilization of the patient after surgery (getting out of bed as soon as fit enough to do so with the support of the nurses).

Any patient who experience calf pain, or shortness of breath in the first-weeks after surgery, needs rapid assessment (usually best carried out by the emergency department of a local hospital) to exclude the possibility of a deep venous thrombosis (a clot in the calf veins) or a pulmonary embolism (a blood clot obstructing a lung blood vessel).

After care

Patients are discharged from hospital wearing padded bandages, and need to return to clinic at approximately one week after surgery. I usually recommend that patients keep Micropore™ tape across the scar (a fresh piece applied each day) for 3-4 weeks, and then apply a simple mosturiser to the scar daily for 4 weeks.

The scar is usually firm and red for at least four weeks, it then usually softens, flattens and fades, over the next three months and achieves its final appearance after about one year.