Week 3 | Assessing and Caring for Surgical Wounds (17171-SP)
- Intentional injury that disrupts blood vessels and causes clotting and cascade of events that leads to wound closure within 2 to 4 weeks
- History of Surgery—18th Century surgeons were apprentices of barbers and butchers
The Surgical Wound
- Generally – acute wounds – Should heal quickly when incision is closed
- Goals for Surgical Wounds
- Prevent complications - SSI (surgical site infection)
- Re-establish tissue integrity and function
- Make cosmetically acceptable
Closure options for surgical wounds
Used to Close Surgical Wounds
- Other approaches to closure
Removal of Staples/Sutures
- Based on location, skin thickness, tension, cosmetic desire
- 3-5 days
Impediments to Surgical Wound Closure
- Poor Wound PERFUSION!
- Non-viable tissue
- Hematoma or seroma
- Surgical Site Infection (SSI)
Surgical Wounds: Complications
Other closure issues
- Mechanical issues during/after surgery
- Systemic Issues
- Increased blood glucose
- Cardiovascular disease
- Personal activities
- Hypertrophic – Within the area of the incision
- Keloid – Beyond incision site
Objectives for Learning Outcomes
After completing this session, you will be able to:
- Discuss surgical approaches creating wounds.
- Identify materials used in surgical wound closure.
- Describe issues related to surgical wound closure.
- Describe interventions to support wound closure.
Betty Hanrahan, MSN, CNS, ARNP-BC, CWCN-AP, CWS, FACCWS, CFCN
Certified Wound Care Nurse; Co-Director, Wound Management Education Program (WMEP) and Wound Management Fundamentals Course (WMFC), Continuing Nursing Education, University of Washington School of Nursing, Seattle; Fellow, College of Certified Wound Specialists