Surgical Wound

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A surgical wound is a cut or incision in the skin, usually made by a scalpel during surgery. A surgical wound can also result from the placement of a drain during surgery. Surgical wounds vary greatly in size. They are typically closed with sutures, but sometimes they are left open to heal. Surgical wounds are classified according to the degree of contaminants present. Classification allows for appropriate risk stratification for the development of complications and assists in guiding appropriate treatment. The risk of complications is based on several factors, including the mechanism of injury, level of contamination, organ system involvement, and the patient’s condition before surgical intervention. Surgical site infection (SSI)—defined by the Centers for Disease Control and Prevention (CDC) as an infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure, or within 90 days if prosthetic material is implanted during surgery—is among the most common preventable complications after surgery. SSIs occur in 2% to 4% of all patients undergoing inpatient surgical procedures. According to a meta-analysis conducted by Dechasa Adare Mengistu et al., the worldwide incidence of surgical site infection among patients was found to be 2.5%.

Negative Pressure Wound Therapy (NPWT) is a wound management technique that uses a vacuum pump to create negative pressure over a wound bed. This method has been increasingly utilized in managing surgical wounds due to its potential positive impact on healing and patient outcomes. It enhances wound healing by reducing infection risk, managing exudates, facilitating faster closure, providing pain management, and improving patient comfort.

Capture Meditech’s SAC (Suction Assisted Closure) device effectively embodies all the attributes of Negative Pressure Wound Therapy (NPWT), providing skilled and efficient treatment. The flowchart below outlines the decision tree for surgical wound classification, aiding the surgeon’s choice in determining where to employ the SAC NPWT device. Generally, NPWT is recommended for use in clean and clean-contaminated wounds, with careful consideration in contaminated wounds. For dirty or infected wounds, NPWT is typically avoided until the infection is controlled and the wound is appropriately debrided.

Image Courtesy: https://aornjournal.onlinelibrary.wiley.com/doi/abs/10.1016/j.aorn.2016.03.011

References:

Surgical Wounds: Types, Risk Factors, and Treatment (healthline.com)

Herman TF, Bordoni B. Wound Classification. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554456/

Onyekwelu I, Yakkanti R, Protzer L, Pinkston CM, Tucker C, Seligson D. Surgical Wound Classification and Surgical Site Infections in the Orthopaedic Patient. J Am Acad Orthop Surg Glob Res Rev. 2017 Jun 13;1(3):e022. doi: 10.5435/JAAOSGlobal-D-17-00022. PMID: 30211353; PMCID: PMC6132296.

Surgical Wounds: Classification, Complication Risk Factors, Assessment, and Care Planning | WoundSource

Surgical Site Infections | PSNet (ahrq.gov)

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