Surgical Wounds

By Kathy Gallagher, DNP, APRN-FNP, CMC, UMC, BC, WCC, CWS, FACCWS Welcome to the first in a series of blogs focusing on acute surgical wound management. Future segments will discuss steps toward developing an acute surgical wound service (ASWS) and tips reflective of successful healing strategies.

By Kathy Gallagher, DNP, APRN-FNP, CMC, UMC, BC, WCC, CWS, FACCWS In 2010, Christiana Care Health System, a 1,000 bed Level I trauma center in Wilmington, Delaware, introduced an acute surgical wound service (ASWS) integration plan in with a single dedicated nurse practitioner, trauma surgeon, and administrative leader. Subsequently, trauma patients with complex wounds experienced decreased morbidity and length of stay. Closely aligned with these numbers, their patient days of negative pressure wound therapy fell from 11+ days in 2010 to 8.2 days in 2018, representing one of the lowest in the nation.

By the WoundSource Editors With an associated cost of $3.5 billion to $10 billion spent annually on surgical site infections (SSIs) and complications in the United States, it is important to know how to assess for surgical wound complications. There is a difference between the normal cascade response and a brewing infection. Symptoms of infection are often the first clue that there is more occurring in the wound than meets the eye.

Surgical site infections (SSIs) are a risk for the more than 10 million patients who undergo inpatient surgical procedures every year in the United States. Between 300,000 and 500,000 Americans develop SSIs annually. SSIs are defined as infections related to an operative procedure that occur at or near the surgical incision within 30 days of the procedure, or within 90 days if prosthetic material is implanted.

In the United States alone, there are between 160,000 and 300,000 surgical site infections (SSIs) each year, representing $3.5 to $10 billion in annual health care costs.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA If you read my last blog on therapeutic interventions to stimulate wound healing, then you may recall the asset that a lymphedema trained therapist can be to your wound care department. A recent patient at the inpatient rehab facility where I am currently the Wound Care Coordinator illustrates this wonderfully.

By the WoundSource Editors Wounds resulting from surgical procedures have many commonalities with wounds of other etiologies. However, there are a few notable differences in their classification, as well as in the recommended care practices that promote the healing of these wounds. In understanding these differences, it is important to understand the classification of surgical wounds.

A limb salvage program aims to prevent major amputations and thus improve patients' quality of life and overall longevity. Despite the efforts of a multidisciplinary team approach, amputation prevention remains a challenging endeavor.1 Providing both physical and socioemotional guidance for patients undergoing a major amputation is crucial for recovery. A multifaceted approach to post-amputation care may seem like a relatively modern concept, but it has deep roots in earlier civilizations.

Dehiscence occurs when a surgical incision that was closed opens, either partially or completely. Dehiscence is most likely to take place within the first two weeks after surgery, but it can occur as late as one month after surgery.

Successful care of surgical wounds begins with a comprehensive assessment of both the wound and the patient, including a clear understanding of the type and class of surgical wound. Psychosocial factors affecting healing and well-being, are essential to consider as well.