Question

1. Describe normal surgical wound healing. What are the risk factors and complications of delayed wound healing? Describe nursing measures for evisceration and dehiscence. (CSLO 1, 4)

Answer 1

Ans) Surgical wound healing, whether by normal or delayed healing, will occur in three phases. Wound healing is not a linear process; rather it progresses differently depending on many patient-related factors. The three phases of wound healing are (1) inflammatory phase, (2) proliferation phase, and (3) maturation phase.

Ris

- Specific Wound Healing Complications and Interventions:
Infection.
Osteomyelitis.
Tissue Necrosis and Gangrene.
Periwound Dermatitis.
Edema and Periwound Edema.
Hematomas.
Dehiscence.

Dehiscence of the abdominal wound, causing a defect in the fascia, is a complication with high morbidity and mortality rates of up to 35 %. Evisceration of abdominal contents, which can occur in dehiscence, usually necessitates more aggressive treatment decisions.

- The nurse should assess this client for wound dehiscence or evisceration. A wound evisceration can occur 4 to 5 days postoperatively following an increase in strain on the incision, such as from forceful coughing, sneezing, or vomiting. Client's often report feeling something has "popped" or opened in the wound.