Complications of the wounds

Carry to early complications of aseptic wounds: bleeding, a hematoma in a wound, a seroma, formation of an inflammatory infiltrate, a wound suppuration, a necrosis of edges of a wound, an eventration of internals. Carry to late complications: postoperative hernia, ligature abscess and fistula, keloid and hypertrophic cicatrix, trophic ulcer, ossification of the cicatrix, contracture.

Wound hematomas are formed in the wounds closed by a seam owing to an incomplete stopping of bleeding during operation or as a result of early secondary bleedings.

Necroses of surrounding tissues – develop at disturbance of microcirculation in the corresponding area at an operational travmatization of tissues, the wrong suture.

Wound fever – its development is promoted by necroses, foreign matters in a wound, a clump of liquid or a blood, disturbance of local blood supply and the general factors influencing the current of a wound process, and also a high contamination of a wound microflora.

Divergence of edges of wounds meet in the presence of the local or general factors complicating an adhesion and at too early excision of seams.

At a laparotomy the divergence of a wound can life full (an eventration – an exit outside of internals), incomplete (integrity of a peritoneum remains) and hidden (the dermal seam remains). The divergence of edges of a wound is eliminated in the operational way.

Prophylaxis of wound complications provides keeping of an asepsis, care of carrying out PST, hemostasis, care with tissues during operations, postoperative control and care of a wound, carrying out immune prevention.

Antibiotics prevention of infectious complications aseptic and the contamination of wounds depends on a type of an operational grant and is shown in case of an appreciable microbial contaminationof a wound or conditional radicalism of its surgical treatment.

Depending on degree of microbial flora all operations share on 4 look: 1) pure or aseptic operations (planned, without opening of a lumen of internals) At pure operations to an antibiotics prevention, as a rule don't prescribe.

2) conditionally aseptic operations (operations with a probable becoming infected, an intervention with opening of a lumen of organs) - the antibiotic is entered before operation, and the following dose within the next 8-12 hours. 3) operations with high danger of a becoming infected - conditional infected (appendectomy) - the preparation is entered before operation, and also within 24-48 hours.

4) "dirty" operations - infected (the emergency interventions concerning purulent processes - antibiotics are entered before operation and then within 3-5 next days.