Nonhealing surgical wounds
What Is it?
As the name implies, nonhealing surgical wounds are wounds from surgical procedures which have not undergone the normal process of healing. As with other types of nonhealing wounds, the three phases of wound healing (the inflammatory, proliferative and remodeling phases) have been prolonged or did not progress in an orderly fashion.
Causes
There are many causes of nonhealing surgical wounds. However, probably the most common cause is wound infection. Wound infections of this type are known as surgical site infections (SSIs), which are estimated to account for 14 to 16 percent of all hospital-acquired infections in the United States. Surgical site infections are believed to cause a majority of deaths involving patients who have undergone surgery. Most infections of surgical sites are caused by bacteria from the skin, but can come from other parts of the body as well. The presence of other medical conditions that can cause decreased immune function, such as diabetes, can complicate wound healing and cause nonhealing surgical wounds.
Who Is at risk
The type of surgery is one risk factor for the development of nonhealing surgical wounds. Operations involving the intestines have a higher rate of SSIs because of the vast amounts of bacteria present there. Aside from that, a poor surgical technique contributes to the rate of infection. Like in any type of wound, patients with poor nutritional status and diabetics have an increased risk for this condition.
Signs and Symptoms
There is no specific cut-off time to determine whether a wound is nonhealing or not. However, most wounds heal in a matter of weeks and achieve 70 percent of their strength in around four months. Follow-up visits with your surgeon are an important component of treatment and will let you know whether your wound is healing properly.
Treatment Options
Nonhealing surgical wounds are treated the same way as other nonhealing wounds. The patient's medical condition which underlies or contributes to poor wound healing should be addressed and controlled sufficiently. Antibiotics, whether topical, oral, or intravenous, may be given to eradicate any bacterial infection and promote healing. Prophylactic antibiotics, which are antibiotics given prior to the surgery to prevent potential infections, may be given for operations with a high risk for infection. These include bowel surgeries and surgeries which last for long periods of time.
Proper wound care is an important factor in the treatment of nonhealing surgical wounds and should be performed religiously. Debridement (cleaning of the wound to remove any debris) should be performed, if necessary, to promote wound healing. The use of vacuum-assisted wound closure has been studied and found to reduce the wound healing time and the length of hospital stay.
Related Articles
Bedsores (Decubitis Ulcers)
What Is It? Bedsores, also known as decubitus ulcers or pressure ulcers, are skin lesions caused by prolonged pressure on different areas of the body...Acute Wounds
An acute wound is an injury to the skin that occurs suddenly rather than over time. It heals at a predictable and expected rate according to the norma...Chronic Wounds
A chronic wound develops when any acute wound fails to heal in the expected time frame for that type of wound, which might be a couple of weeks or up ...Dehisced Wounds
Wound dehiscence is one of the most common complications of surgical wounds, involving the breaking open of the surgical incision along the suture. Ty...Diabetic Wounds
Diabetes mellitus can be virtually harmless if controlled, but the state of abnormally high blood glucose levels associated with the condition can lea...Gangrene
Gangrene is a condition in which body tissues decay and eventually die as a result of inadequate blood supply. Although it can happen in any part of t...Infected Wounds
What Is It? Infected wounds are wounds in which bacteria or other microorganisms have colonized, causing either a delay in wound healing or deteriora...Necrotizing fasciitis
What Is It? Necrotizing fasciitis is a type of bacterial skin infection which predominantly affects the skin but may also expand to include the subcu...Pressure Ulcer
A pressure ulcer, also known as a bedsore or decubitus ulcer, is a wound of the skin caused by prolonged, unrelieved pressure to that area. Pressure u...Pyoderma gangrenosum
What Is It? Pyoderma gangrenosum is a rare disease, occurring in approximately one person per 100,000, which causes inflammation and ulceration of th...Soft Tissue Radionecrosis
What Is It? Soft tissue radionecrosis (STRN) refers to the death (necrosi) of soft tissues as a result of exposure to ionizing radiation. It is a cou...Surgical Wounds
A surgical wound, also known as an incision, is a wound made by a cutting instrument such as a scalpel. Surgical wounds are made in a sterile environm...Venous Leg Ulcers
Venous ulcers are the most common type of ulcers occurring in the lower limbs, accounting for more than half of all ulcer cases. A venous ulcer typica...Acute arterial insufficiency
What is It? Acute arterial insufficiency is a medical condition in which the tissues do not receive enough oxygen and nutrients (ischemia) due to poo...Biofilm-Infected Wounds
Biofilms in wounds are a form of infection that is made up of living microbes that are capable of forming colonies. Biofilms are generally compos...Burns
A burn refers to any damage to body tissue due to heat, chemicals, radiation or electricity. It is estimated that burns cause approximately three- to ...Ischemic Wounds
Ischemic wounds occur as a direct result of blocked blood flow to medium and small vascular beds in the body. This condition is called arterial insuff...Osteomyelitis (Bone Infection)
What Is It? Osteomyelitis is a bone infection caused by bacteria or, in rare cases, a fungus. Your bones are a living tissue and, like other tissues ...Osteoradionecrosis
What Is it? Osteoradionecrosis (ORN) is a condition in which bone tissue dies as a result of radiation exposure. Normally, bone tissue is able to reg...Partial Thickness Burns
A partial thickness burn (also known as a second degree burn) is a burn that affects the top two layers of skin, called the epidermis and hypodermis. ...Radiation Injury
What Is It? A radiation injury is tissue damage caused by exposure to ionizing radiation, including gamma rays, beta rays and X-rays. Causes There ...Skin Disorders
Skin disorders broadly encompass any cutaneous (skin) injury or infection. There are many different types of skin disorders ranging from a rash or itc...Spider Bites
Only a few spiders are dangerous and strong enough to pierce the human skin and cause a spider bite. Frequently, bites that you suspect to be caused b...Traumatic wounds
Traumatic wounds are typically defined as cuts, lacerations or puncture wounds which have caused damage to both the skin and underlying tissues. Acute...Varicose Veins
Varicose veins are enlarged or swollen veins in the legs, feet and other parts of the body. However, they are typically found in the lower limbs. This...Human and Animal Bites
Human and animal bites are relatively common and can result in minor injuries such as puncture wounds, scrapes, cuts or bruising. They most commonly o...