Week 6 | Surgical Wounds (16181-SP)

Photo of suture wound recently uncovered.

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Topics

Surgical Wounds

  • 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

  • Primary
  • Secondary
  • Tertiary

Used to Close Surgical Wounds

  • Sutures
  • Staples
  • 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

  • Hemorrhage
  • Dehiscence
  • Evisceration
  • Fistula

Other closure issues

  • Mechanical issues during/after surgery
  • Systemic Issues
    • Increased blood glucose
    • Cardiovascular disease
    • Obesity
    • Malnutrition
  • Personal activities
    • Smoking/drugs

Scar Formation

  • Hypertrophic – Within the area of the incision
  • Keloid – Beyond incision site ​

Objectives for Learning Outcomes

After completing this session, you will be able to:

  1. Discuss surgical approaches creating wounds. 
  2. Identify materials used in surgical wound closure. 
  3. Describe issues related to surgical wound closure. 
  4. Describe interventions to support wound closure.
Course summary
Available: 
10/01/2016
Expires: 
12/02/2017

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

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