In this article, we will discuss Brief Note on Wound Complications (Post Abdominal Surgery). So, let’s get started.
Wound Complications
Wound Infection
Postoperative wound infection is an infection in the tissues of the incision and operative area. It can occur from 1 day to many years after an operation, but commonly occurs between the fifth and tenth days after surgery. The microbes flourishing in the surgical site because of poor preoperative preparation, wound contamination, poor antibiotic selection or the inability of an immunocompromised patient to fight off infection. Factors increasing an individual’s risk include malnutrition, decreased blood volume, lengthy preoperative stay, hypothermia, poor tissue perfusion, diabetes, and the use of immunosuppressant’s such as steroids. Advanced age and obesity increase an individual’s risk of having
infection at the surgical site.
Cellulitis
It usually occurs after bowel-related surgery within first week, but can be seen as late as third postoperative week even after leaving hospital.
Gas Gangrene
It is uncommon and may be life-threatening after abdominal surgery.
Wound Sinus
It is a late infectious complication from a deep chronic abscess that can occur after apparently normal healing.
Septicemia (Systemic Inflammatory Response Syndrome)
Wound infection can cause separation of the wound layers, incisional hernias, abscesses and tissue destruction (gangrene or necrotizing fasciitis), which can result in physical and/or functional deformity. Bacteria from the infection can spread, causing an overwhelming, life-threatening, systemic infection
(sepsis). Severe sepsis is the systemic inflammatory response, plus infection, plus the presence of organ dysfunction.
Wound Dehiscence
It is due to failure of wound closure technique and usually occurs between 7 and 10 days postoperatively.
Incisional Hernia
It occurs in 10-15% of abdominal wounds appearing within first year, but can be delayed up to 15 years after surgery. The risk factors include obesity, distension and poor muscle tone, wound infection and multiple use of same incision site.
Other complications
• Hiccough
• Vomiting
• Urine retention
• Abdominal distension
• Peritonitis
• Burst abdomen
• Paralytic ileus
• Renal failure
• Urinary calculi
• UTI
• Incontinence
• Insomnia/depression
• Post operative psychosis and delirium
• Loss of appetite/weight
• Constipation
• Indigestion
• Less efficient immune system
• Sluggish liver & renal function
• Postural hypotension/supine hypotensive syndrome
• General muscle weakness
• Loss of mobility
• Kypho-scoliosis
• Myalgia
• Peripheral nerve injuries