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Post operative bleeding: what’s normal?

Patients will often experience a small amount of bleeding from their surgical site after discharge from hospital.

This can often be seen as staining on garments or surgical tapes.

Although this can be understandably alarming, it is very normal, and rarely sign of a serious complication.

 

What is minor or normal post operative bleeding?

Drop a tablespoon or two of water on a tissue or paper towel, and note the size of the liquid patch.

This is a normal amount of blood to ooze out of your incision immediately following your surgery (ie during the first few days post op).

Sometimes, the blood is mixed with other body fluid which makes it look like there’s been more bleeding than there has.

Bleeding can also be mistaken for the clear/yellow drain fluid seen in the image on the right.

post operative bleeding

If the following bleeding occurs, please contact the clinic:

More blood loss than the amount indicated above

Small amounts of blood loss, two or more times in a 24 hour period

Bleeding that starts 2 or more weeks after surgery

If you have a sudden increase in pain that cannot be comfortably improved by pain relief along with rash, fever, flu like symptoms or a malodorous smell.

It is helpful if you are able to send a photo to the post op phone showing how much blood has come out onto your dressings, garment or tape, so we can gauge the degree of bleeding.

If you experience large amounts of sudden blood loss, proceed to your nearest emergency department.

What causes post operative bleeding?

In most cases, this is residual blood from normal bleeding during your procedure (ie when tiny blood vessels are cut during the operation).

When this blood finds its way out through an incision or drain (for example, after abdominoplasty) it can actually be a good thing, because it means the blood won’t remain in your body, causing firm, persistent bruising or a haematoma.

If the blood is dark red, this usually indicates old blood – that is, not bleeding that is currently occurring.

If the blood is bright red, it indicates fresh blood and bleeding that is currently occurring or has recently happened. Loosing large amounts of fresh blood after surgery can be an indication that your blood vessels aren’t clotting as we’d normally expect.

Other times it can be due to the fragile operative site being bumped or injured while dressing, sleeping/rolling over or sutures being pulled due to sudden movements or stretching before your body’s incisions have a chance to form a strong enough seal to hold themselves together.

Compression garments are an important part of preventing post operative bleeding because they restrict movement somewhat and also apply pressure and support for the wound site.

What should I do if my wound bleeds after surgery?

If the bleeding is of a normal amount:, elevate the surgical site and apply firm pressure on the area for 20-30 minutes.

Avoid getting the area wet for 24 hours, as this allows time for the incision line to seal.

If the sight of blood makes you feel anxious or upset, you can cover the tape or dressing with another piece of fresh tape or padding/gauze so that you don’t see it. Don’t remove the tape or dressing unless your post op nurse or Dr Sharp instructs you to.

If bleeding continues, or is of a larger amount, it is important to contact your surgeon.

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The above information is general in nature and does not constitute medical advice. If you have concerns following surgery please consult your post operative instructions, and if these do not address your concerns, call your surgeon’s clinic for individual advice. 

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