Prevention and management of wound complications

Abstract

A wound can be defined as the disturbance of the skin’s normal structure and function and the soft tissue beneath it.1 Wound complications are major contributors to both early and late postoperative morbidity.2 It can cause significant physical and emotional distress to both patients and the treating physician. Most surgeons will agree that wound complications can be challenging to treat and everything possible should be done to prevent it from happening. Wounds are classified as clean-, clean-contaminated-, contaminated- or dirty wounds. Clean wounds can be described as an incision into tissue, other than hollow viscera, in which neither infection nor inflammation is present followed by primary closure afterwards. Cleancontaminated wounds result from intentional entry into the respiratory, gastro-intestinal, genital or urinary tracts without remarkable contamination. Contaminated wounds can be characterized by unintentional entry into a hollow viscus, a major disruption in sterility, or encountering areas of nonpurulent inflammation. Dirty wounds include old wounds with residual devitalised tissue, perforated viscera or current clinical infection.