IDENTIFICATION AND TREATMENT OF SURGICAL WOUND COMPLICATIONS

Christopher L. Cole, DO, FACOS

Surgical Associates, Inc

Tulsa, OK

OBJECTIVES

1. Review of physiology of wound healing

2. Discuss barriers of wound healing in surgical patients

3. Identification of complications associated with postoperative surgical wounds and management.

SURGICAL WOUND CLASSIFICATION

FISTULAS

1. Enterocutaneous Fistulas

2. Enteroatmospheric Fistulas

3. Colocutaneous Fistulas

4. Gastrocutaneous Fistulas

5. Other Fistulas

CAUSES OF FISTULAS

- Anastamotic Leaks

Ischemia

Previous Radiation

Injury

Foreign Body Erosion

Abscess

Trauma

Inflammatory Bowel Disease

SIGNS OF FISTULA- Usually about 4-7 days postop

- Fever

- Bloody, Purulent Drainage

- Enteric Fluid

TREATMENT OF FISTULAS

-Control Drainage

-Management of Sepsis

-Fluid and Electrolyte Management

-Nutritional Support

-Typically Months Before Definitive Surgical Therapy