When you have closed an operation wound, there may start postoperative bleeding, reactionary and secondary haemorrhage. The type and reasons may be as follows:
It occurs during the first 48 hours of the surgery. It may be due to a dislodged clot in a vessel, or a ligature has slipped.
It occurs after 8 to 14 days after surgery. When the wound becomes infected and erodes a vessel. It may usually be quite a small one, but sometimes a larger one. One of the purposes of monitoring a patient immediately after an operation is to watch for reactionary haemorrhage, so make sure your staff observe him carefully, and take his pulse and blood pressure regularly.
Management of delayed haemorrhage:
If a patient's wound bleeds, apply firm local pressure and packing. If it bleeds rapidly, There may be a chance that an artery has been injured.
Minor bleeding probably comes from subcutaneous tissues, and is unlikely to be serious. If local pressure fails to control bleeding, take the patient back to the theatre and open his wound. Remove the sutures and tie or coagulate the bleeding vessels under local anaesthesia. Make sure the patient takes antibiotics.