Complications of wound healing Hemorrhage Blood dyscrasias or

Complications of wound healing

Hemorrhage �Blood dyscrasias or extensive malignancies or in alcoholics with cirrhosis patients

Hematoma �Localized collection of blood underneath tissue

Hypertrophic scars �Occurs when there is excess production of collagen tissues �Inappropriately large, red, raised and hard �Remains confined to the wound edge �Regress in time

Keloid formation �Is an even greater protrusion of scar tissue �Extend beyond the wound edge �Tumors – like masses �They are permanent without any tendency to subside. �Pain, tenderness and hyperesthesia (increased sensitivity) �Scar can be excised but tend recur

Contracture �Excessive contraction results in deformity �Shortening of muscle or scar tissue results from excessive fibrous tissue formation �Mainly seen in burns

Wound dehiscence �Separation and disruption of previously joined wound edges �Occurs due to – infection (may cause an inflammatory process) �- obese individuals – adipose tissue interfere with healing

Wound Evisceration �Protrusion of wound contents �Occurs when wound edges separate to the extent that intestines protrudes through the wound

Adhesions �These are bands of scar tissue between or around organs or tissues �Adhesions may occur in the abdominal cavity or between the lungs and pleura

Wound infection �It is a serious consequence of a common cause of delayed wound healing �Causes -Due to lack of blood supply, lack of oxygen, contamination or exposure to pathogens.

Clinical manifestions �Increased bloody drainage �Purulent drainage �Odor from wound and drainage �Erythema around the entire wound �Increasing pain �Fever �Leukocytosis- WBC count above the normal �General malaise

Diagnostic measure �Swab culture of wound drainage �While obtaining the swab – remove the excess visible drainage first – then swab the wound bed

Surgical wound – 4 th or 5 th post op day inflammation is expected. �Fever, tenderness, pain, disability and increased WBC count �Pus discharge usually foul smelling and purulent – varied in color