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Postoperative wounds are those wounds acquired during surgical procedures. Postoperative wound healing occurs after surgery and normally follows distinct bodily reactions: the inflammatory response , the proliferation of cells and tissues that initiate healing , and the final remodeling .
Wound bed, wound edge and periwound skin should be examined before the initial treatment plan is devised. It should also be re-assessed at each visit or each dressing change. For wound bed, the following parameters are assessed: Tissue type; presence and percentage of non-viable tissue covering the wound bed; Level of exudate; Presence of infection
Depending on the amount of drainage, a patient may have the drain in place one day to weeks. Drains will have protective dressings that will need to be changed daily/as needed. The routine use of drains for surgical procedures is diminishing as better radiological investigation and confidence in surgical technique have reduced their necessity.
The dressing should be changed and the wound irrigated with normal saline at least twice each day. [4] In addition, it is recommended to administer an antibiotic active against staphylococci and streptococci, preferably vancomycin when there is a risk of methicillin-resistant Staphylococcus aureus . [ 4 ]
The dressings used for the technique include foam dressings and gauze, sealed with an occlusive dressing intended to contain the vacuum at the wound site. [1] Where NPWT devices allow delivery of fluids, such as saline or antibiotics to irrigate the wound, intermittent removal of used fluid supports the cleaning and drainage of the wound bed. [6]
Ideally, wound dressings should be changed daily to promote a clean environment and allow for daily evaluation of wound progression. Highly exudative wounds and infected wounds should be monitored closely and may require more frequent dressing changes. [33] Negative pressure wound dressings can be changed less frequently, every 2–3 days. [42]
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The Eloesser flap is a surgical procedure developed by Dr. Leo Eloesser in 1935 at the San Francisco General Hospital. [1] It was originally intended to aid with drainage of tuberculous empyemas , since at the time there were no effective medications to treat tuberculosis .