LEARNING CONTENT ON WOUND CARE WOUND CARE Wound care is the process in which preventing wound complications are

e being done. It involves the assessment and cleaning the wound. Wound care is done in every wound to prevent infection and other complications. DIFFERENT COMPLICATIONS

B. Fever: It is often accompanied by feeling chilled. This fever may because of the inflammatory process and due to toxins that the microorganism produced.

C. Hot Incision: This happens as the body sends infection fighting blood cells to the site of infection. Some of these may be leukocytes, histamines and others.

D. Swelling/Hardening of the Incision: infected incision may begin to harden as the 1. INFECTION main causes of post-operative morbidity in abdominal surgery most common form is superficial wound infection occurring within the first week presenting as localized pain, redness and slight discharge usually caused by skin staphylococci (Staphylococcus arues) Wound infection results from microbes flourishing in the surgical site because of poor preoperative preparation, wound contamination, poor antibiotic selection, or the inability of an immunocompromised patient to fight off infection. F. Drainage From the Incision: Foul-smelling drainage or pus may begin to appear on an infected incision. It can range in color from blood-tinged to green, white or yellow. The drainage from an infected wound may also be thick, and in rare cases, WHAT ARE THE SIGNS AND SYMPTOMS OF INFECTION chunky. E. Redness: An incision that gets red, or has red streaks radiating from it to the surrounding skin may be infected. Some redness is normal at the incision site, but it should decrease over time, rather than becoming more red as the incision heals. tissue underneath are inflamed. The incision itself may begin to appear swollen or puffy as well.

A. Malaise: One of the most common symptoms of a systemic infection, or an infection that is moving through your body. Patient may feel generalized body weakness. Feeling to be tired easily even without exerting effort.

G. Pain: the pain should slowly and steadily diminish as you heal. If pain level at the surgery site increases for no apparent reason, it may be developing an infection in the wound. It is normal for increased pain if increase with activity or decrease with pain medication, but a significant and unexplained increase in pain should be discussed with the surgeon

 Fully soaked dressing THINGS TO DO: 1) Report immediately to the physician 2) Comply to antibiotic regimen strictly, Right dose and Right time 3) Do not expose further the wound Pallor Delayed capillary refill Rapid respiratory rate Rapid pulse rate Confusion Restlessness PREVENTION OF WOUND INFECTION a) Comply to antibiotic regimen strictly b) Do not rub, scratch, of play the wound c) Do not put lotion and powder unto the wound d) Clean the wound from inner to outer e) Do not let the dressing to be soiled PREVENTION 2. BLEEDING/HEMMORHAGE Severe bleeding from a wound can be life-threatening, depending on the amount of blood loss, how difficult the bleeding is to control, how long the bleeding goes unchecked and other injuries that may be present. The term hemorrhage refers specifically to blood being lost at a rapid rate. 1. For the first day or two, do not move the affected area too much in order to avoid causing bleeding. The pressure of the bandage should help to prevent bleeding. 2. A small amount of blood on the dressing is normal. If bleeding seems persistent, apply pressure firmly and steadily over the dressing for 10 to 15 minutes. This will usually stop the bleeding but if it does not, call the doctor promptly. 3. Dot expose directly to sunlight 4. do not take a bath under hot water 5. do not rub, scrub, and remove clots SIGNS AND SYMPTOMS Low urine output 3. WOUND DEHISENCE THING TO DO IF THIS HAPPENS a) Apply pressure directly on the wound b) Use clean clothe to cover if possible c) Seek medical attention immediately

Dehiscence is a surgical complication where the edges of a wound no longer meet. It is also known as wound separation.

come out of the incision (evisceration). Evisceration is an emergency and should be treated as such.

Affects about 2% of mid-line laparotomy wounds. Serious complication with a mortality of up to 30%. Due to failure of wound closure technique. Usually occurs between 7 and 10 days post-operatively. Often heralded by serosanguinous discharge from wound. Should be assumed that the defect involves the whole of the wound. I. II. WHAT TO DO IF THIS HAPPENS: Call an emergency response team or bring patient tonearest hospital Cover the opening and organs with the cleanest sheet or bandage material you have, after wetting it thoroughly. If you have been bandaging your wound, you should have the supplies to cover the tissue with sterile bandages. The fabric/bandage needs to be moist, to prevent it from adhering to tissue. If you have sterile saline, use it to saturate the bandage or towel. If not, bottled or tap water can be used.

sudden increase in abdominal pressure, due to coughing, sneezing, vomiting, bearing down to have a bowel movement or lifting a heavy object, causes an abdominal wound to open it may also caused by infection

UNDER NO CIRCUMSTANCES should you attempt to push the organs back Symptoms of post operative wound dehiscence include: Failure of the staples or stitches Separation of the wound edges Wound swelling Fluid draining from the wound Tissue protruding from the wound How to Prevent Dehiscence and Evisceration: 4. WOUND EVISCERATION Evisceration is a rare but severe surgical complication where the surgical incision opens (dehiscence) and the abdominal organs then protrude or Bracing - When doing any activity that increases abdominal pressure (sneezing, coughing, vomiting, laughing, bearing down for a bowel movement) hold pressure over your incision using your hands or a pillow. This can both prevent dehiscence and minimize pain during activity. in to the abdominal cavity. If the worst case scenario has happened and loops of intestine have pushed out of the incision, gather them in the wet sheet or bandage and keep the patient calm and seated or lying down.

Prevent Constipation - Constipation is common after surgery, and straining to have a bowel movement puts unnecessary stress on your incision. Prevent constipation with proper nutrition after surgery, or if you are already constipated, ask your surgeon for medication to help. Proper Incision Care - Proper incision care will not only speed healing, but it helps prevent infection, which can weaken the incision and increase the chances of dehiscence. Prevent coughing and sneezing - If youve had surgery and your allergies are acting up or you have a cough, be proactive about keeping sneezing and coughing to a minimum. Repetitive coughing and sneezing can slowly weaken your incision, which can slow healing and (in some cases) lead to dehiscence. Avoid Lifting If your doctor says you are not allowed to lift anything heavier than 5 pounds for 2 weeks after surgery, he isnt kidding. Lifting objects can place stress on your incision that can cause it to open.

http://www.patient.co.uk/doctor/common-post-operative-complications http://surgery.about.com/od/aftersurgery/ss/DehiscenceEvisc_5.htm http://surgery.about.com/od/aftersurgery/ss/DehiscenceEvisc_4.htm

http://surgery.about.com/od/aftersurgery/qt/SignsInfections.htm http://www.mdguidelines.com/wound-infection-postoperative

TEACHING PLAN ON WOUND COMPLICATION AND MANAGEMENT I. DESCRIPTION OF THE LEARNER: He is a 30 year old, male, and a resident of Ucab, Itogon, Benguet. He is an elementary graduate and able to read, speak, write and understand English, Tagalog, Ilocano, Kankanaey, and Ibaloi. He is a Roman catholic and a father of my patient who undergone Emergency exploratory laparotomy. It was his first time to have a child with exploratory laparotomy or and surgery. II. LEARNING NEED: Wound complication and management III. LEANING DIAGNOSIS: Readiness for enhance knowledge: wound care related to lack of exposure IV. TIME ALLOTMENT: 20 minutes V. LEANING PLAN BLOS LEARNING CONTENT TEACHING STRATEGY AND MATERIALS NEEDED After teaching the father of client on wound care, he will able to 1. Define wound care properly using his own words Definition wound care One-on-one teaching Picture analysis -pamphlet Instant oral feedback: ask the client to define wound care properly using his own words EVALUATION CRITERIA

2.

State at least 3 out of 4 surgical wound complication correctly

Wound complications

One-on-one teaching -pamphlet

Instant oral feedback: ask the client to state at least 3 out of 4 surgical wound complication correctly

3. Define each wound complications included in

Definition of each wound complications

One-on-one teaching -pamphlet

Instant oral feedback: ask the client to define each wound complications included in the discussion using his own words

the discussion using his own words correctly 4. Identify properly at least 2 signs and symptoms of each complications 5. Enumerate correctly at least 2 preventions of each complications 6. State at least 2 things to do if the wound complications happens correctly Things to do if wound complications happens Preventions of each complications One-on-one teaching pamphlet One-on-one teaching pamphlet Signs and symptoms of each complications One-on-one teaching Pamphlet

correctly

Instant oral feedback: ask the client identify properly at least 2 signs and symptoms of each complications

Instant oral feedback: ask the client to enumerate correctly at least 2 preventions of each complications Instant oral feedback: ask the client to state at least 2 things to do if the wound complications happens correctly