Wound Care Health Article

Complications

• Hematoma: dressings should be inspected for hemorrhage at intervals during the first 24 hours after surgery. A large amount of bleeding is to be reported immediately. Concealed bleeding sometimes occurs in the wound, beneath the skin. If the clot formed is small, it will be absorbed by the body, but if large, the wound bulges and the clot must be removed for healing to continue.
• Infection: the second most frequent nosocomial (hospital acquired) infection in hospitals is surgical wound infections with Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Prevention is accomplished with meticulous wound management. Cellulitis is a bacterial infection that spreads into tissue planes. Systemic antibiotics are usually prescribed. If the infection is in an arm or leg, elevation of the limb reduces dependent edema and heat application promotes blood circulation. Abscess is a bacterial infection that is localized and characterized by pus. Treatment consists of surgical drainage or excision with the concurrent administration of antibiotics.
• Dehiscence (disruption of surgical wound) and evisceration (protrusion of wound contents): this condition results from sutures giving way, infection, distention, or cough. Pain results and the surgeon is called immediately. Prophylactically, an abdominal binder may be utilized.
• Keloid: refers to excessive growth of scar tissue. Careful wound closure, hemostasis, and pressure support are used to ward off this complication.

Results

The goals of wound care include reducing risks that inhibit wound healing, enhancing the healing process, and lowering the incidence of wound infections.

Health care team roles

Members of the health care team actively work to reduce patients' exposure to infections, as well as to administer prescribed treatments and patient education, which includes teaching home wound care.

PERIODICALS

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René A. Jackson, RN