Surgical Wounds

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by the WoundSource Editors

Antimicrobial: Describing the property pertaining to any of several categories of agents that are intended to be toxic to pathogenic organisms, including antibacterials, antiprotozoals, antifungals, and antiparasitics.

Chronic wound: A wound that has failed to re-epithelialize after three months, usually because of failure to progress past the inflammatory phase of wound healing.

Intraoperative phase: The time period beginning when the patient is brought to the operating suite and ending when the patient’s procedure is complete, typically when skin is closed and dressed and the patient is transferred to the post-anesthesia or recovery unit.

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Management of Surgical Wounds

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.

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Surgical Wound Healing

By the WoundSource Editors

The number of surgical procedures performed in the United States has been increasing annually by as much as 300% over a 10-year period. Although technological advances in surgical procedures have allowed some procedures to be performed using minimally invasive techniques, many operations still require incisions, which require special care to prevent dehiscence and surgical site infections (SSIs). SSIs occur in 2% to 4% of all patients undergoing surgical procedures, and they are among the most expensive inpatient harms, adding approximately $30,000 to the total hospital cost per infection.

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Preventing Surgical Site Infections

By the WoundSource Editors

The Centers for Disease Control and Prevention (CDC) define a surgical site infection (SSI) as "an infection that occurs after surgery in the part of the body where the surgery took place." The CDC go on to say the infection can be superficial involving just the skin or more serious infections can occur that involve deeper structures, such as tissue under the skin, organs, or implanted devices or materials. The CDC offer tools and guidelines to prevent SSIs and provide education to the public. Public education includes tips and advice on how to prevent patient surgical sites from becoming infected. Although such steps may not always prevent a surgical wound from becoming infected, it is always important to involve the patient in postoperative care.

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Surgical Wound Infection Assessment

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.

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Temple University School of Podiatric Medicine

Article Title: Graduating Student Nurses' and Student Podiatrists' Wound Care Competence: A Cross-Sectional Study
Authors: Kielo E, Salminen L, Suhonen R, Puukka P, Stolt M
Journal: J Wound Care. 2019;28(3):136-145
Reviewed by: Stephanie Golding, class of 2020, Temple University School of Podiatric Medicine

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Acute Surgical Wound Service

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.

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Acute 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.

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Preventing Cross-Infection

by Hy-Tape International

Infections are common and serious complications associated with post-surgical wounds. In wounds resulting from clean surgery, 8% become infected among the general population and 25% among those over 60 years of age. Preventing these infections can help reduce costs, improve patient outcomes, and save lives. It is critical that health care professionals understand the risk of cross-contamination and take steps to prevent it.

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SSI

by the WoundSource Editors

Surgical site infections (SSIs) account for 20% of total documented infections each year and cost approximately $34,000 per episode. SSIs are responsible for increased readmission rates, length of stay, reoperation, morbidity, and mortality, as well as increased overall health care costs.1,2