A surgical wound is a cut or an incision in the skin that is usually made by a scalpel during surgery. A surgical wound can also be the result of a drain placed during surgery. Surgical wounds vary greatly in size. They are usually closed with sutures but are sometimes left open to heal.
Surgical wounds can be classified into one of four categories, according to guidelines set by the American College of Surgeons. These categories depend on how contaminated or clean the wound is, the risk of infection, and where the wound is located on the body.
- Class I: These are considered clean wounds. They show no signs of infection or inflammation. They often involve the eye, skin, or vascular system.
- Class II: These wounds are considered clean-contaminated. Although the wound may not show signs of infection, it is at an increased risk of becoming infected. This can be due to its location. For example, surgical wounds in the gastrointestinal tract may be at a high risk of becoming infected.
- Class III: A surgical wound in which an outside object has come in contact with the skin is classified as having a high risk of infection and considered a contaminated wound. For example, a gunshot wound may contaminate the skin around where the surgical repair occurs.
- Class IV: This class of wound is considered dirty-contaminated. They include wounds that have been exposed to fecal material.
Surgical wounds are created when a surgeon makes an incision or a cut with a surgical instrument called a scalpel. A wide variety of medical circumstances might require a surgery. The size of a wound depends on the type of procedure and location on the body.
Any surgical procedure will create a surgical wound. The likelihood of a surgical wound infection after surgery is between one and three percent (John Hopkins Medicine).
Risk factors for developing a surgical wound infection include having diabetes or a weakened immune system. Emergency surgeries, abdominal surgeries, and surgeries that last longer than two hours bring a higher risk of infection (John Hopkins Medicine).
Surgical wounds are frequently monitored to make sure they are healing properly. Signs of a surgical wound infection include increased pain and redness around the cut. Delayed healing, the presence of pus, a foul smell, or drainage from the wound are other signs. In some cases, an infected surgical wound can appear dried out or deeper. Fever may accompany this type of infection.
A physician can diagnose a surgical wound infection by examining the wound, assessing symptoms, or taking a culture of fluid drained from the wound.
Treatment for a surgical wound sometimes depends on where it’s located on the body. Surgical dressings are normally placed over the wound. The surgical dressing may need to be changed regularly. The skin around the surgical wound will likely need to be cleaned, often with salt water and soap. The wound may also need to be irrigated with salt water. This involves filling a syringe with salt water and spraying the skin around the wound.
Home care for a surgical wound may involve some of the same procedures, including frequent dressing changes and cleaning. Over-the-counter pain medication can also reduce discomfort. Often, patients are discharged from the hospital before a surgical wound has completely healed. It is essential that patients follow all at-home care instructions. Following directions properly will promote healing and decrease chances of an infection.
The prognosis for a surgical wound that is properly healing is usually good. Following infection-control recommendations can increase the chances that a surgical wound heals well.