Post-Surgical Wounds.
What is a Post Surgical Wound?
Postoperative wounds are incisions or cuts in the skin made during surgical procedures. They require meticulous post-operative care to ensure optimal wound healing and to prevent complications.
Surgical wound healing process
The healing process of these wounds typically follows distinct stages:
1. Inflammatory phase, where the body's immune response kicks in;
2. Proliferative phase, where new tissue and cells form;
3. Remodeling phase, where the wound matures and strengthens over time.
Surgical wound assessment: How to treat surgical wounds to avoid complications
Comprehensive postoperative wound assessment and management are essential, as is an understanding of the wound healing process and appropriate treatments/products. Regular assessment helps monitor wound healing and prevent surgical wound complications (SWCs).
Postoperative wound management is essential to prevent infections and associated complications such as surgical wound dehiscence, surgical site infections (which are among the most common SWC and healthcare-associated infections (HAIs) globally), hypergranulation, and more. Therefore, proper management of these wounds is critical.
The National Institute for Health and Care Excellence (NICE) in the UK has issued guidelines regarding cleaning and dressing the wound, administering antibiotics, and performing wound debridement. Maintaining a moist environment to protect the wound from contamination, and using suitable dressings are crucial for promoting healing and preventing infections.
Characteristics of an ideal wound dressing:
According to the report Incision Care and Dressing Selection in Surgical Wounds: Findings from a Series of International Meetings, the ideal dressing should:
- Protect the wound from contamination
- Maintaining a moist wound environment
- Minimize the risk of skin damage (e.g., blistering)
- Allow patient mobility
- Stay secure until sutures or staples are removed
It's worth noting that while dressing wear time may vary depending on wound status, surgery type, and patient cooperation, it is important to choose dressings that manage exudate and allow for extended wear. Additionally, undisturbed wound healing and fewer dressing changes tailored to the patient's situation are gaining increasing attention, as they result in minimized tissue trauma, reduced pain and stress, minimal disturbance to the wound bed, and an improved quality of life for the patient.
NICE Recommendations: What measures should be taken to treat surgical wounds?
1. Wound Cleansing and Dressing:
- After surgery, change dressings using antiseptics without direct contact with the wound.
- Keep the wound untouched for 48 hours, cleaning only with sterile saline. Afterward, patients may bathe carefully.
- If the wound is opened to drain pus, use tap water for cleaning.
- Wounds healing by secondary intention require interactive dressings; consult healthcare professionals for recommendations.
- Use gentle irrigation with a syringe to remove debris, avoiding trauma and promoting healing. Excessive cleaning can delay the process.
2. Treatment with antibiotics:
- Administer antibiotics if a surgical site infection is suspected.
- Choose an antibiotic that targets the most likely causative organisms.
3. Wound Debridement
Debridement is a critical aspect of wound management, essential for preparing the wound bed to facilitate re-epithelialization.
Debridement is the process of removing dead or damaged tissue to promote faster and more effective healing. This can be done through various methods, including surgical, biological, enzymatic, and autolytic debridement.
Visit NIH website for more information about debridement techniques.
Debridement Guidelines:
- Use primary closure and debridement for minor wounds.
- For deep and major wounds, use negative pressure dressings and continuous tension devices.
- Employ gauze, eusol, and enzymatic treatments for debridement of surgical site wounds.
Source: An updated guidelines on postoperative wound management from the International Journal of Medical and Biomedical Studies. You can refer to the full article here.
How to Treat Post-Surgical Wounds with Flaminal®
Flaminal® is a primary dressing and autolytic debridement solution suitable for various wound types, including post-surgical ones.
Flaminal®:
- maintains a moist wound environment,
- continuously debride the wound,
- offers antimicrobial protection.
Flaminal® contains a unique enzyme system and moisturizing agents that promote faster healing by dissolving necrotic tissue and fibrinous slough and creating an optimal wound environment.
It forms a protective barrier that maintains moisture and prevents wound infection accelerating endogenous healing.
Flaminal® is gentle on the skin, suitable for long-term use, and helps improve the quality of life for patients.
Case Reports: Post-Surgical Wound Treatment with Flaminal®
Here you find case studies and posters for treatment of post-surgical wounds.