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How I Treat

Surgical Wound Complications: A Slideshow

James V. Stillerman, MD, CWSP
  • Figure 1A

    Figure 1A

    Figure 1A. Here one can see a postop wound dehiscence following a C-section that is completely open, treated with negative pressure and debridement.

  • Figure 1b

    Figure 1B

    Figure 1B. Here is the C-section dehiscence initial wound closure.

     

  • Figure 1C

    Figure 1C

    Figure 1C. The C-section patient returned with suspicious symptoms of recurrence.

     

  • Figure 1D

    Figure 1D

    Figure 1D. In the same presentation as Figure 1c, the wound was opened with evisceration of small bowel and patient sent to OR for repair.
     

     

  • Figure 1E

    Figure 1E

    Figure 1E. The patient was treated with moist wound care and the wound closed a second time. Surgeons utilized a C-section support binder with this patient to lift the abdominal pannus.

     

  • Figure 2A

    Figure 2A

    Figure 2A. A 34-year-old female status-post hysterectomy for cervical carcinoma via Pfannenstiel incision with postop wound dehiscence. Treatment consisted of wound debridement, moist wound care, and no antibiotic therapy (11/14/22).

  • Figure 2B

    Figure 2B

    Figure 2B. The patient has significant undermining (as indicated by the arrows) (11/23/22).

  • Figure 2C

    Figure 2C

    Figure 2C. Undermining has been excised with local anesthesia in our clinic. Note running interlocking hemostatic chromic sutures. Negative pressure wound therapy started 75 mmHg continuous utilizing black foam only. White foam not indicated since all of the undermining has been excised (11/30/22).

  • Figure 2D

    Figure 2D

    Figure 2D. Chromic sutures have now been removed. Excellent granulation tissue now present. Wound vac therapy increased to 125 mmHg (12/14/22).

  • Figure 2E

    Figure 2E

    Figure 2E. Wound continues to improve. NPWT discontinued (1/3/23).

  • Figure 2F

    Figure 2F

    Figure 2F. Wound continues to improve despite radiation therapy on 1/5/23 and chemotherapy on 1/9/23 (1/23/23).

  • Figure 2G

    Figure 2G

    Figure 2G. The wound is almost closed (2/13/23).

Click here to read "How I Treat Surgical Wound Complications."

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