Plus-Hex CLINICAL
Appendix 1 . Types of postoperative complications , their definitions and signs ( continued on next page ).
Postoperative wound complication
Surgical site infection ( SSI )
Deep incisional SSI with SWD , spreading signs of infection and rising cellulitis in the proximal limb
Surgical wound dehiscence ( SWD )
Definition
An infectious process seen at the surgical incision site in the muscle layer or organ space . An SSI can be localised or systemic [ 2 ] .
SSIs are classified into three categories [ 2 ] : 1 . Superficial incisional 2 . Deep incisional 3 . Organ / space
A separation of the incision site that may or may not cause exposure of the underlying structures . Separation can involve single or multiple sites , or the complete incision , and can occur without warning [ 4 ] .
An open traumatic wound that has been surgically closed and dehisces would not be classified as a true SWD [ 4 ] .
Signs
Localised [ 2 ] :
• Increased tenderness / pain
• Swelling / induration
• Purulent drainage
• Deep abscessation
• Separation of wound edges
• Erythema / redness
Systemic [ 2 ] :
• Spreading cellulitis
• Purulent drainage from drain sites
• Organ / space abscess
• Postoperative pyrexia
• Positive blood cultures or aseptically obtained swab samples
• Exaggerated erythema
• Tension
• Swelling
• Discomfort / pain
• Serosanguineous discharge
• Seroma / haematoma
• Ongoing inflammatory signs for longer than 5 days [ 4 ] .
SWD with multiple areas of breakdown ; the wound is inflamed but not infected
Peri-wound maceration
The breakdown of the skin ' s barrier caused by prolonged exposure to moisture / water on the skin ' s surface . The skin cells become saturated and swell , softening the skin ' s surface and making it more suspectable to friction and trauma [ 5 ] .
• Initially , the skin may appear white or grey
• Wrinkled skin
• Later stages : erythema
• Satellite wounds
• Erosion [ 5 ]
Erosion of surrounding skin due to exposure to moisture
Volume 39 ( 4 ) • August 2024
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