Section III. EFFECTS OF SURGERY ON THE INTEGUMENTARY SYSTEM
When wounds occur, a variety of effects may result, such as immediate loss of all
or part of organ functioning, sympathetic stress response, hemorrhage and blood
clotting, bacterial contamination, and death of cells. Careful asepsis is the most
important factor in keeping these effects to a minimum and promoting the successful
care of wounds.
POSSIBLE NEGATIVE EFFECTS
Wound Infection. The first sign of wound infection is increased pain in the
incision. The incision shows signs of infection by becoming reddened, warm, and
swollen and by draining pus-like material. If a patient develops a wound infection, it is
important to prevent it from spreading to other patients.
Wound Separations. This is the breaking apart of the edges of the
incision. The causes of wound separation are malnutrition (which interferes with the
normal healing process), defective suturing, infection, and excessive strain on the
wound from retching, coughing, etc. Dehiscence and evisceration are two types of
wound separations (see Figure 4-1).
Dehiscence. This is the separation (opening) of the wound edges
without the protrusion of organs. Small openings are not unusual and may be closed or
supported with sterile tape. The openings always need to be supported and the wound
observed regularly for further openings.
Evisceration. This is the separation of the wound edges with the
protrusion of organs. This rarely happens, but it is a serious complication when it does
happen. The patient is usually taken to surgery immediately for resuturing.
4-10. TYPES OF WOUND HEALING
One of the most fundamental and marvelous defensive properties of living
organisms is the power to heal wounds. The reaction of tissues to a surgical incision
differs only in degree from that caused by a laceration (usually occurring in accidents).
There are always bacteria on the skin that are carried into deeper tissues, even when
the wound is a surgical incision. Clean wound healing is an intricate, exact biological
process. The two types of wound healing discussed in this subcourse are primary and