Wound Care after Your Plastic Surgery Procedure

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Description

Wound healing is a long and complex process. While surgical incisions do take place in a controlled, antiseptic environment, healing follows the same stages for these types of wounds as it would for any other serious injury.

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• Plastic surgery

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• Publié par: brianevansplasticsurgery
• Publié le: 27 octobre 2016
• Nombre de lectures: 2
• Langue: English

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Wound Care after Your Plastic Surgery Procedure

Wound healing is a long and complex process. While surgical incisions do take place in a controlled, antiseptic environment, healing follows the same stages for these types of wounds as it would for any other serious injury. From hemostasis to inflammation, proliferation to maturation, each stage carries its own risks and characteristics that dictate whether the wound will heal successfully without complication. Given that it can take more than a year for an incision to completely finish healing, the possibility of a complication arising over such a lengthy period of time is not remote.

Surgical wound dehiscence is a serious postoperative complication that can increase the risk of post surgical mortality by between 14 and 50 percent depending on the location of the wound itself and nature of the surgical procedure involved. Dehiscence is a term referring to the failure of a wound to heal after a surgical procedure has taken place. At its most extreme, patients suffering from dehiscence in the abdominal area can experience dangerous exposure or protrusion of the bowel or other organs. However, even in non life-threatening situations, dehiscence can cause lingering pain, infection risk, and a lower quality of life.

Up to 3 percent of patients undergoing a surgical procedure experience dehiscence, making this a common complication. There are many different factors that can come into play and trigger dehiscence. Medical conditions such as obesity, malnutrition, jaundice, diabetes, and anemia can limit the recuperative response. Obesity can be responsible for a higher risk of infection as well as present a challenge to the surgeon in terms of properly closing a wound.

Altered insulin levels in diabetic patients can affect the body's ability to generate collagen and make it harder for them to achieve strong wound closure. Advanced age can also play a role in decreasing the body's ability to heal after surgical injury. From a procedural standpoint, poorly placed sutures, excessive wound tension, broken sutures, slipped knots, or inadequate tissue bites can all contribute to increasing the risk of wound dehiscence.

Traditional management of wound dehiscence can be divided into 2 categories. The first involves intervention prior to the surgery itself, as well as specific measures undertaken by the surgical team during the actual procedure. Patients are asked to make changes to their lifestyle, if necessary, to better prepare their systems for healing. These changes can include adopting a high-protein diet to promote the production of enzymes critical to collagen generation and healing, the cessation of smoking, and the stopping of any medications that could have an anticoagulant effect. During the surgery, several steps can be taken to ensure that the risk of infection is as low as possible.

Blood volume, blood glucose control, and the maximization of tissue perfusion are vital for the promotion of swift healing. If the risk of dehiscence is greater due to the circumstances of the patient or the location of the incision, retention sutures are sometimes used, although they do not represent a guarantee against complication.

The second category of standard wound dehiscence management is concerned with treating the complication should it present itself at any point post surgery. Standard treatment for a dehisced wound does not differ from that of any other open wound. The situation is evaluated to determine whether secondary surgical closure will be required. If not, then several different types of topical therapy can be employed, as well as more involved treatments. The most common methods involve dressings that help maintain a moist environment, which help promote the formation of granular tissue and epithelialization. Prior to the application of dressings, standard debridement of a dehisced wound includes sterile skin preparation and drape with Betadine. Necrotic fat and fibrin exudate is excised with Metzenbaum scissors, and the wound is irrigated with 10 percent acetic acid. A dressing is then placed on the wound.

Dry dressings are usually laid over-top of hydrogels or alginates, which can absorb any drainage as necessary. These bio-occlusive alginate dressings allow the wound to breathe while still providing a barrier against water, viruses, and bacteria, lowering the risk of infection. Silver-based antimicrobial agents and dressings can be used, or even combined with other gels. Silver can be extremely effective at controlling bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE).

ConsultDr. Brian Evans MDfor more details. Dr. Brian Evans is a plastic surgeon in West Hills, California and is affiliated with multiple hospitals in the area, including

Cincinnati Veterans Affairs Medical Center and San Joaquin Community Hospital. Mr. Dansker can surely sort out your all doubts. Call him at [phone]

For more details please visit:http://www.drbrianevansplasticsurgery.com