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The wound usually appears red and can be accompanied by drainage. Clinicians delay re-opening the wound unless it is necessary due to the potential of other complications. If the surgical wound worsens, or if a rupture of the digestive system is suspected the decision may be to investigate the source of the drainage or infection. [2] [3]
Wound dehiscence following an inguinal hernia repair. Wound dehiscence is a surgical complication in which a wound ruptures along a surgical incision . Risk factors include age, collagen disorder such as Ehlers–Danlos syndrome , diabetes , obesity , poor knotting or grabbing of stitches , and trauma to the wound after surgery.
Chronic wound pain is a condition described as unremitting, disabling, and recalcitrant pain experienced by individuals with various types of chronic wounds. [1] Chronic wounds such as venous leg ulcers, arterial ulcers, diabetic foot ulcers, pressure ulcers, and malignant wounds can have an enormous impact on an individual’s quality of life with pain being one of the most distressing symptoms.
Research into hormones and wound healing has shown estrogen to speed wound healing in elderly humans and in animals that have had their ovaries removed, possibly by preventing excess neutrophils from entering the wound and releasing elastase. [26] Thus the use of estrogen is a future possibility for treating chronic wounds.
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]
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
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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 ]
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