Surgical Wound

What is a surgical wound?

A surgical wound is a cut or 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.

What are the types of surgical wounds?

Surgical wounds can be classified into one of four categories. 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 because of 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 into contact with the skin has a high risk of infection and is 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. These include wounds that have been exposed to fecal material.

What causes surgical wounds?

Surgical wounds are created when a surgeon makes an incision or cut with a surgical instrument called a scalpel. A wide variety of medical circumstances require surgery. The size of a wound depends on the type of procedure and location on the body.

What are the risk factors for surgical wound infections?

Any surgical procedure will create a surgical wound. The likelihood of a wound infection after surgery is between 1 and 3 percent.

Risk factors for developing a surgical wound infection include having other medical issues, such as diabetes or a weakened immune system. Smokers, older adults, and people who are overweight also have an increased risk of infection. Emergency surgeries, abdominal surgeries, and surgeries that last longer than two hours bring a higher risk of infection, too.

What are the symptoms of surgical wound infections?

Surgical wounds are frequently monitored to make sure they are healing properly. Infections may affect only the skin, tissue under the skin, or implants, according to the Centers for Disease Control and PreventionTrusted Source. Signs of a surgical wound infection include:

• increased pain and redness around the wound
• delayed healing
• the presence of pus
• a foul smell, or drainage from the wound

In some cases, an infected surgical wound can appear dried out or deeper. Fever may also be a common symptom.

How are surgical wound infections diagnosed?

A physician can diagnose a surgical wound infection by examining the wound, assessing symptoms, or taking a culture of fluid drained from the wound.

How is a surgical wound treated?

Treatment for a surgical wound sometimes depends on where it’s located on the body. Surgical dressings are normally placed over the wound and 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

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.

What are some complications of surgical wounds?

When surgical wounds cause infection, it typically occurs within 30 days of surgery. Infections may be red, painful, hot to the touch, or drain pus. To treat infections, your physician may prescribe an antibiotic, or they may have to open the wound to clean it.

What is recovery like for surgical wounds?

Recovery varies and can last for weeks to months. Your surgeon should be able to give you specific information on when you can go back to work, exercise again, and return to your daily routine.

What is the outlook for surgical wounds?

The outlook for a surgical wound that is properly healing is good. Following infection control recommendations can increase the chances that the wound heals well.

References

Caring for surgical wounds at home. (2014, February)
ouh.nhs.uk/patient-guide/leaflets/files/110307wounds.pdf

Frequently asked questions about surgical site infections. (2010, December 14)
cdc.gov/HAI/ssi/faq_ssi.html

Incision care. (2015, April 4)
med.umich.edu/surgery/mast/

Surgical site infections. (n.d.)
hopkinsmedicine.org/healthlibrary/conditions/surgical_care/surgical_site_infections_134,144/

Surgical wounds classification. (n.d.)
med.umich.edu/surgery/mast/

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