Whether you go in for a routine procedure or are brought in for emergency surgery, you expect to be good to go once you’re discharged from the hospital. Unfortunately, some wounds may refuse to heal. These chronic non-healing wounds affect millions of people every year, with the cost to treat them estimated at approximately $30 billion annually. While there can be underlying causes for the complications, such as obesity, diabetes, and cancer, stubborn wounds can affect anyone regardless of a surgeon’s meticulous care. Aside from the medical costs, wound complications also cost lives. Here are seven wound care complications to be aware of following your surgery.
Seven Potential Wound Care Complications
The most common wound care complication is infection; in fact, John Hopkins Medicine reports that surgical site infections (SSIs) affect up to 3% of people undergoing surgery. Why? Because the skin is a natural barrier against infection, and any break in the skin can be an open invitation for germs such as Staphylococcus, Streptococcus, and Pseudomonas. SSIs generally occur within 30 days after surgery, and they are categorized in three ways:
- Superficial incisional SSI. This infection attacks only the area of the skin where an incision was made.
- Deep incisional SSI. This infection occurs beneath the incision area, affecting muscles and their surrounding tissue.
- Organ or space SSI. This infection becomes present in any area of the body not involved in the actual surgery, often within an organ or a space between organs.
The good news is that, if taken care of quickly, most SSIs can be treated using only antibiotics. More severe SSIs may require additional surgery or procedures, so if you suspect an SSI, speak to your doctor ASAP.
A form of infection, osteomyelitis attacks a bone by traveling through the bloodstream or spreading from nearby tissue (Infections may also occur if the bone itself was exposed to germs during the initial injury or procedure). Antibiotic therapy can often treat the situation if caught early; if not, amputation may be necessary. While amputation may seem extreme, it may be recommended for fear the infection may spread to other limbs. While osteomyelitis may not initially show signs and symptoms, especially in the very young or the very old, the Mayo Clinic says to be aware of these warning signs following surgery:
- Swelling, warmth, and redness over the area of the infection
- Pain in the area of the infection
While often associated with frostbite, gangrene can occur anytime there is a loss of blood supply to a certain area of the body, usually the extremities such as the hands or feet. When tissues in the extremities are denied oxygen and nutrients, the tissue dies. If gangrene is suspected, it needs to be treated immediately to halt its spread. Untreated, it can lead to amputation and even death. Medical News Today reports that you should seek treatment if you experience any of the following after surgery:
- Loss of color in a body part: The area will become discolored and eventually turn dry and dark. The color will change from red to black in dry gangrene, or it will become swollen and foul-smelling in wet gangrene. Gas gangrene will produce particularly foul-smelling, brownish pus.
- Shiny appearance to the skin and the shedding of skin, with a clear line forming between affected and healthy skin.
- Pain that is later followed by loss of sensation and an inability to move the part.
- The part is cold to the touch and there is a loss of pulse in the arteries.
4. Periwound Dermatitis
Periwound is the tissue surrounding a wound. When not properly cared for, dermatitis may occur, turning the periwound area red, swollen, and sore, sometimes with small blisters. This condition can prevent the wound itself from closing and healing, so if you suspect periwound dermatitis, it’s important to seek treatment immediately to avoid its spread and to ensure your wound remains closed.
5. Periwound Edema
Another complication affecting the periwound area is edema, swelling caused by excess fluid trapped within the body's tissues. Edema can slow or even stop the healing process, and may even result in additional wounds. Edema can also cause small vessels to compress, decreasing blood flow to parts of the body. The Mayo Clinic says to watch for the following wound care complications; if you experience any of these, you should contact your physician:
- Swelling or puffiness of the tissue directly under the skin, especially in the legs or arms
- Stretched or shiny skin
- Skin that retains a dimple after being pressed for several seconds
- Increased abdominal size
6. Wound Dehiscence
Surgical staples, sutures, and adhesives are not perfect, and can begin to gradually come apart, or in rare circumstances, split completely open. This is known as wound or incision dehiscence, and it could be caused by poor suturing (for example, if the surgeon applies stitches too tightly), too much stress to the wound area, a weakened immune system (diabetes and cancer patients, for example, may have compromised skin integrity), or infection. If you see that your wound is coming apart, contact your physician immediately. Also, be sure to read our story, 10 Ways to Keep Your Surgical Wound From Opening.
While not too common post-surgery, hematomas (a collection of blood, usually clotted, outside of a blood vessel that can spread into tissues where it does not belong) have been known to occur in some patients. Hematomas can lead to infection as well as wound dehiscence, in which the wound opens up. Symptoms of a hematoma may include:
- Headache or neurologic problems such as weakness on one side, difficulty speaking, loss of balance, confusion, or seizures.
- Epidural hematoma symptoms: back pain, Back pain, weakness, loss of bowel or bladder control
- Nail pain, weakness, or loss
- Abdominal pain
As with any post-surgical conditions, it’s important to see your doctor if you suspect you have a hematoma.
Most surgeries go off without a hitch; unfortunately, wound care complications can arise. One way to help prevent these scenarios is by requesting your surgeon use BandGrip. BandGrip is a new, non-invasive method of wound closure that can significantly reduce the risk of infection, wound dehiscence, and more, as it doesn’t involve sewing or stapling (and by tiling BandGrip, it can even be used for large surgical incisions). You can see how BandGrip works here, and be sure to talk to your doctor about its benefits before your next procedure to avoid the potential pitfalls of surgery.