Encyclopedia of Health and Medicine

wound care 281
Postoperative Complications
Infection is the most common postoperative
wound complication. Rarely a surgical wound
may bleed. Though some degree of bleeding at the
incision for the first 24 hours after surgery is normal
for most operations, bleeding that saturates
the bandage requires immediate assessment by the
surgeon or hospital nursing staff. Extended irritation
at the incision site (redness farther than one
half inch from the incision), pus, and FEVER are
early indications of infection that the surgeon
needs to evaluate. Obesity, diabetes, and PERIPH-
ERAL VASCULAR DISEASE (PVD) can affect the circulation
of BLOOD in the body, particularly to the limbs.
NOSOCOMIAL WOUND INFECTION
About 500,000 of the 27 million Americans who
undergo surgery every year develop postoperative
wound infections. About 25 percent of postoperative
infections are nosocomial (also called
iatrogenic)—that is, they occur as a consequence
of exposure to pathogens in the hospital environment.
Proper wound care minimizes the risk for
INFECTION of any kind and supports optimal HEAL-
ING.
People who have these conditions should be alert
to changes in the surgical wound that could suggest
infection.
Discomfort or PAIN is a common and expected
complication for a period of time after the operation,
the severity and duration of which depends
on the kind of operation. Restricting use of the
operated area minimizes discomfort. The surgeon
will prescribe appropriate ANALGESIC MEDICATIONS to
relieve pain.
Return to Bathing or
Showering and Normal Activities
Most surgical wounds are closed enough to permit
showering 24 to 48 hours after surgery. Getting
the incision wet does not affect the skin closures
(sutures, staples, or adhesive strips). Bathing (sitting
in a tub of water) should wait until the incision
is completely healed (2 to 3 weeks), unless it
is possible to sit in the water without getting the
incision wet. Soaking in bath water softens the
skin at the incision’s edges and may allow BACTERIA
to gain entrance, causing infection. The full return
to normal activities depends on the operation and
the person’s individual rate of healing and can
take place anytime from a few days to 3 months.
See also SURGERY BENEFIT AND RISK ASSESSMENT.