Overview of Surgical Wounds, Texas

A non-healing surgical wound can occur after surgery when a wound caused by an incision doesn’t heal as expected. This is usually caused by infection – a rare but serious complication.

Causes of poor wound-healing depend on the type and location of the procedure, health condition and other factors. To correctly classify the cleanliness and condition of wounds, the CDC has established classification definitions composed of four classes of wound statuses.

Risk Factors for Surgical Wound Complications

Two common complications of surgical wounds are infections and wound dehiscence. As such, the following signs should be looked out for in the post-operative wound review: fever, haematoma, seroma, separation of wound edges and purulent discharge from the wound.

If wound infection is suspected, active management should be considered. In the first instance, wound swabs for culture and sensitivity should be taken. Next, empirical antibiotic therapy can be commenced on the basis of the suspected pathogen .

Antibiotic therapy should be subsequently tailored once the offending pathogen and its sensitivity have been identified. Debridement of non-viable and infected tissue is another effective method of treating and preventing further extension.

Wounds with equivocal signs do not require immediate antibiotic therapy but should be closely and regularly monitored for any progression of signs.

The CDC classification system is used for surgical wound documentation and involves the patient’s risk for infection and complications.

Any condition that decreases effectiveness of host defenses is a risk factor for developing surgical wound complications. The following list includes conditions that are known to affect surgical wound complication rate:

Immunocompromised state:

Autoimmune disease such as rheumatoid arthritis or lupus; cancer; long-term corticosteroid therapy; or any patient receiving chemotherapeutic agents or medications that dampen immune response.

Altered states of perfusion:

Chronic respiratory conditions such as chronic obstructive pulmonary disease, vascular disorders including peripheral vascular disease, hypertension or hypotension, coagulopathy, smoking

Functional status:

Dependent status, generalized debility or immobility predisposing the patient to skin breakdown, affecting self-care capacity, including ability to obtain adequate nutrients.

Conclusion

Optimal management of surgical wounds is an important part of post-operative recovery and health care professionals should monitor the process of acute wound healing, prevent wound complications and treat appropriately if complications arise.

The key elements of post-operative wound management include timely review of the wound, appropriate cleansing and dressing, and early recognition and intervention of wound complications.

Treatment Reference