Post-Laparoscopic Surgery: Managing Umbilical Discharge and Concerns

Postoperative umbilical bleeding after laparoscopic surgery?

Hello doctor, I underwent laparoscopic surgery to remove a right ovarian teratoma on October 8th.
On October 9th, I had my dressing changed and a hydrogel patch applied.
The instructions indicated that if there were no abnormalities, I could keep the patch on until my follow-up appointment on October 21st.
However, yesterday, October 14th, I noticed some oozing blood under the hydrogel patch at the umbilical incision, and there is a dark indentation to the left of the umbilicus.
It doesn't feel particularly painful or warm, but today I observed that the area under the hydrogel patch around the umbilicus has turned a dark red color due to the patch.
I am unsure what could be causing this discoloration (it looks like a bruise in the photos).
Given this situation, would you recommend that I return for an earlier follow-up to change the dressing?

Miss Zhang, 20~29 year old female. Ask Date: 2020/10/16

Dr. Huang Yuande reply Obstetrics and Gynecology

If there is redness, swelling, heat, and pain, it may indicate an infection at the wound site, and a return to the hospital for examination is necessary.
However, if it is merely a bruise, the area has not expanded, and the wound is gradually drying, then an earlier follow-up appointment may not be required.

Reply Date: 2020/10/16

More Info

After undergoing laparoscopic surgery for the removal of a right ovarian teratoma, it's understandable to have concerns about the healing process, especially when you notice changes at the incision site. Based on your description, it seems that you are experiencing some discoloration and possible bleeding at the umbilical incision site, which can be concerning.

Firstly, it is important to recognize that some degree of bruising or discoloration can occur after surgery. This is often due to the trauma of the surgical procedure itself, which can cause blood vessels to break and lead to the accumulation of blood under the skin, resulting in a bruise. The fact that you are not experiencing significant pain or warmth at the site is a positive sign, as these could indicate an infection or other complications.

However, the presence of black or dark red discoloration, especially if it is accompanied by any drainage or unusual changes in the wound, warrants a closer look. The black color could suggest necrosis (tissue death) or a hematoma (a localized collection of blood outside of blood vessels), which may require medical attention.
Given that you have noticed these changes, it would be prudent to contact your healthcare provider or surgeon for advice. They may recommend an earlier follow-up appointment to assess the wound and ensure that there are no complications. It is always better to err on the side of caution when it comes to post-operative care.
In terms of managing your recovery, here are some general recommendations:
1. Keep the Area Clean and Dry: Ensure that the incision site is kept clean. Follow your healthcare provider's instructions regarding bathing and changing dressings. If you notice any signs of infection (increased redness, swelling, warmth, or discharge), seek medical attention promptly.

2. Monitor for Symptoms: Keep an eye on your symptoms. If you experience increased pain, fever, or any other concerning symptoms, contact your healthcare provider immediately.

3. Follow-Up Care: Attend all scheduled follow-up appointments. These are crucial for monitoring your recovery and addressing any concerns that may arise.

4. Avoid Strenuous Activities: While it may be tempting to resume normal activities, it’s important to avoid heavy lifting or strenuous exercise until you receive clearance from your doctor.

5. Nutrition and Hydration: Maintain a balanced diet and stay hydrated to support your healing process. Proper nutrition can aid in recovery and help your body heal more effectively.

In summary, while some discoloration and minor bleeding can be normal after surgery, the changes you are observing should be evaluated by a healthcare professional. It is always best to consult with your surgeon or healthcare provider to ensure that your recovery is on track and to address any potential complications early on. Your health and peace of mind are paramount, so don’t hesitate to seek help when you have concerns.

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