This document provides information on post-operative care, including common complications, their prevention and treatment. It discusses care of patients in the post-anesthesia care unit and criteria for discharge. Some immediate complications discussed are respiratory and cardiovascular issues. Long term complications include infections, DVT and wound healing problems. The importance of early mobilization and physiotherapy to aid recovery is also covered.
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
The post operative period begins from the time the patient leaves the operating room and ends with the follow up visit by the surgeon. The post operative care is provided by – PACU
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
The post operative period begins from the time the patient leaves the operating room and ends with the follow up visit by the surgeon. The post operative care is provided by – PACU
Post Operative Care | PACU | Complications | Treatment Yashasvi Verma
Post operative period is the most crucial and
critical span of time after completion of surgery
In this period numerous complications occur and if not treated on time can prove fatal hence increasing the mortality rate .
The specialized care provided to the patient after completion of surgery till the patient is fully conscious
This specialized care is provided in a specialized area called PACU
SEVERAL POST OPERATIVE COMPLICATIONS LIKE
HYPOXIA , HYPERTENSION , HYPOTENTION , HYPO THERMIA , HYPERTHERMIA , MODIFIED ALDERT SCORE , PAIN ASSESMENT AND TREATMENT , POST OPERATIVE NAUSEA AND VOMITING , ETC. MIGHT OCCUR .
Pre operative and post-operative surgical care - a brief medical study martinshaji
HAPPY PHARMACIST DAY
Preoperative information required to be provided to the patient includes postoperative activities to be expected (such as deep breathing and coughing and early mobilization); pain management; and any other specific information relevant to the type of surgery they are having and to the individual themselves.
this details all about Pre operative and post-operative surgical care
please comment
thank you ..
Principles of surgery. Day case surgery is a rapidly evolving surgical sub speciality that seeks to eliminate the need for prolonged admission in surgical patients and the attendant complications of prolonged immobilization. It is based on the documented evidence that most post op patients does not require specialised post op care and hence can be allowed to recover at home. This form of surgery appeals to patients and their families due to the fact that it allows only minimal interruption of patient's social life
Anesthesia complications range from minor to catastrophic.
complications of general anesthesia might be due to difficulty in airway management or ventilation.
Also the complication might be due to cardiac arrhythmias and poor response to anesthetic effect during induction or maintenance or even the emergence from anesthesia.
So, the the systematic response to the effect of the anesthesia may occur at any time during surgery.
Some of the complications:
Hypoxia, arrhythmia, hypotension , hypertension, regurgitation and aspiration, hypothermia hypoglycemia, coronary ischemia, embolism, persistent apnea delayed recovery , and many others.
also regional anesthesia has its complications like nerve injury, post spinal headache.
Toxicity from local anesthesia is one of the important complication might occur during local infiltration.
Post Operative Care | PACU | Complications | Treatment Yashasvi Verma
Post operative period is the most crucial and
critical span of time after completion of surgery
In this period numerous complications occur and if not treated on time can prove fatal hence increasing the mortality rate .
The specialized care provided to the patient after completion of surgery till the patient is fully conscious
This specialized care is provided in a specialized area called PACU
SEVERAL POST OPERATIVE COMPLICATIONS LIKE
HYPOXIA , HYPERTENSION , HYPOTENTION , HYPO THERMIA , HYPERTHERMIA , MODIFIED ALDERT SCORE , PAIN ASSESMENT AND TREATMENT , POST OPERATIVE NAUSEA AND VOMITING , ETC. MIGHT OCCUR .
Pre operative and post-operative surgical care - a brief medical study martinshaji
HAPPY PHARMACIST DAY
Preoperative information required to be provided to the patient includes postoperative activities to be expected (such as deep breathing and coughing and early mobilization); pain management; and any other specific information relevant to the type of surgery they are having and to the individual themselves.
this details all about Pre operative and post-operative surgical care
please comment
thank you ..
Principles of surgery. Day case surgery is a rapidly evolving surgical sub speciality that seeks to eliminate the need for prolonged admission in surgical patients and the attendant complications of prolonged immobilization. It is based on the documented evidence that most post op patients does not require specialised post op care and hence can be allowed to recover at home. This form of surgery appeals to patients and their families due to the fact that it allows only minimal interruption of patient's social life
Anesthesia complications range from minor to catastrophic.
complications of general anesthesia might be due to difficulty in airway management or ventilation.
Also the complication might be due to cardiac arrhythmias and poor response to anesthetic effect during induction or maintenance or even the emergence from anesthesia.
So, the the systematic response to the effect of the anesthesia may occur at any time during surgery.
Some of the complications:
Hypoxia, arrhythmia, hypotension , hypertension, regurgitation and aspiration, hypothermia hypoglycemia, coronary ischemia, embolism, persistent apnea delayed recovery , and many others.
also regional anesthesia has its complications like nerve injury, post spinal headache.
Toxicity from local anesthesia is one of the important complication might occur during local infiltration.
Presentation on Post operative care by doctors of Anwer Khan Modern Medical College and Hospital.
Revised by our Professor and Head of Department of Neurosurgery Dr. Dewan Shamsul Asif sir.
Source- Bailey's and Love, Washington Manual of Surgery.
Surgery Resident clinical seminar on the management of a 60yr old male with upper gastrointestinal bleeding presented to the department of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
3. LEARNING OBJECTIVES:
• Need of immediate post-op care
• Common post-operative problems
• Anticipation & prevention of common complications
• Identification & Treatment
• Enhancement of recovery
• Systematic discharge
6. POST- ANESTHESIA CARE
• Patient is handed over to a dedicated PACU working under observation of trained
staff, along with complete patient information & nature of surgical intervention.
PACU management involves:
• Resuscitation
• Difficult airway management
• Scheduled vitals monitoring
• Drugs
• Discharge criteria out of PACU
7. PACU DISCHARGE CRITERIA
• Conscious
• Maintaining SPO2
• Normothermic
• Vitally stable & Pain free
• Proper medications prescribed
• No concern related to surgical procedure
9. IMMEDIATE RESPIRATORY COMPLICATIONS
• Upper airway obstruction
Causes
Vocal
Cord
dysfunctio
n
Laryngo
-spasm
Persistent
relaxation
of Airway
Muscles
Soft
tissue
edema
Hematom
a
Foreign
body
10. CONTINUED…
• Impaired adequacy of ventilation (NM blockade, Anesthetic agents, Opioids)
• Supplemental O2
• Hypoxemia (Ac. Pulmonary Edema, bronchospasm, pneumothorax, Aspiration, PE)
• If spontaneously breathing, supplemental oxygen 15L/min using a non re-breathing mask
• If not breathing spontaneously, Endotracheal tube insertion or other invasive intervention
• Surgery specific (Vocal cord Palsy, Neck hematoma, bleeding)
11. EARLY AND LATE RESP. COMPLICATIONS
• Fever
• Malignant Hyperthermia 104˚due to Halothane or Succinylcholine( IV Dantrolene,
100% Oxygen, correct Acidosis, Cooling blankets)
• Bacteremia 30-45 mins (Blood Culture and Empiric Antibiotics)
• Atelectasis 1st POD (Auscultation, Chest X-ray, Improve ventilation, Bronchoscopy)
• Pneumonia 3rd POD (Sputum culture, Antibiotics)
• UTI 3rd POD (UCE, Antibiotics)
• DVT 5th POD (Doppler USG, Anti-coagulation therapy)
• Wound infection 7th POD
• Deep Abscesses 10-15th POD (USG guided drainage or Surgery)
17. CONTINUED…
• Urinary retention
• Catheterization should be done if when an operation is expected to last 3 hours or
more, or when large volumes of fluids are administered.
• UTI
• Low Urine Output (less than 0.5 ml/kg/hour)
1. Fluid deficit (Urinary Na < 10-20 mEq/L)
2. Acute renal failure (Urinary Na > 40 mEq/L)
18. CENTRAL NERVOUS SYSTEM
• Post operative disorientation/coma may result from various causes:
• Hypoxia
• May be secondary to sepsis
• Blood gas analysis and Respiratory support
• ARDS
• B/L pulmonary infiltrates, hypoxia with no evidence of CCF
• Positive end expiratory pressure therapy
• Correct sepsis
19.
20. CENTRAL NERVOUS SYSTEM
• Delirium Tremens
• Alcoholics
• Hallucinations and combative behavior
• Intravenous Benzodiazepines
• Hyponatremia
• May occur after surgery due to combination of large volumes of sodium free fluids (like
DW) and elevated ADH levels in response to trauma/surgery.
• Confusion, convulsions, coma and death
• Include Na in IV fluids
• Osmotic diuretics might help
21. CENTRAL NERVOUS SYSTEM
• Hypernatremia
• Induced by large unreplaced water loss
• Confusion, lethargy, coma
• Do rapid fluid replacement with half DW or DS soln.
• Ammonium intoxication
• Occurs in cirrhotic undergoing a portocaval shunt procedure
22. ABDOMINAL SURGERY COMPLICATIONS
• Paralytic ileus
• Nausea, Vomiting, Anorexia, mild bowel distension with no pain, absence of flatus
and bowel movements
• Adequate hydration and maintain electrolyte levels
• Return of intestinal function occurs as Small bowel > Larger bowel > Stomach
• Local infection / Anastomotic leakage
• Persistent abdominal pain, focal tenderness and fever spike (masked if deep seated
abscess)
• USG or CT for collection along with guided drainage
23. CONTINUED…
• Early mechanical bowel obstruction
• Paralytic ileus not resolving after 5-7 days after surgery
• X-ray: dilated gut loops and air fluid levels
• CT scan Abdomen helps
• Surgical intervention is required
• Ogilvie Syndrome
• Paralytic ileus of colon
• Seen in elderly sedentary patients ( Alzheimer’s, Nursing homes) who become further
immobile due to surgery
• Larger abdominal distension (Tense but no pain), x-ray : massively dilated colon
• Iv Neostigmine and long rectal tube
26. COMPLICATIONS OF ORTHOPEDIC SURGERY
• Damage to the neurovascular supply of the extremity
• Compartment Syndrome
• Increased pressure in Osseo-fascial compartments that hinder adequate tissue
perfusion
• Pain, pallor, pulselessness, paralysis, paresthesia
• Treatment:
• Circumferential cast split and dressings cut down to skin
• Limb elevation
• Fasciotomy
30. UROLOGY
• Loss of urinary catheter patency
• Transurethral resection syndrome
• Problems related to continued bladder irrigation
31. GENERAL POST-OP PROBLEMS
• Hemorrhage
• Primary -- At the time of surgery
• Reactionary -- within 24 hours of surgery
• Secondary -- Several days after surgery
32. CONTINUED…
• PONV
• Risk Factors:
• Female gender (1)
• Non-smoker (1)
• History of motion sickness or PONV (1)
• Post-op opioid treatment (1)
• Apfel Scoring for probability of PONV
• 0 =10 %
• 1= 21 %
• 2= 29 %
• 3= 61 %
• 4= 78 %
33. CONTINUED…
• Treatment of PONV
• Relieve Pain & Anxiety
• Maintain BP
• Proper hydration
• Combination of various drugs may help:
• HT3 receptor antagonists (Ondansetron)
• Steroids
• Phenothiazines
• Anti-histamines
34. CONTINUED…
• Hypothermia & Shivering
• Causes
• Loss of thermo regulatory control due to anesthesia
• Exposure of patient during surgery
• Evaporation of ani-septic
• Treatment:
• Temperature monitoring intraoperatively
• Active warming devices
35. CONTINUED…
• Deep Venous thrombosis
• Thrombosis of one or more deep veins usually of the lower limb
• Calf pain, swelling, erythema, warm limb and engorged veins
• Investigations
• Duplex Doppler Ultrasound
• Venography
• Prevention
• Non-Pharmacologic: Compression stockings and Calf pump
• Pharmacologic: Parenteral anticoagulation initially followed by longer term warfarin or new
anticoagulants
• Surgical: Caval filter to avoid PE
36. STRATIFICATION OF THE SURGICAL PROCEDURE
AND ASSOCIATED RISK OF DVT
• Low
• Maxillofacial surgery
• Neurosurgery
• Cardiothoracic surgery
• Medium
• Inguinal hernia repair
• Abdominal surgery
• Gynecological surgery
• Urological surgery
• High
• Pelvic Surgery
• Total knee and hip replacement
37.
38. DRAINS
• Placed to avoid collection of blood, serosanguinous purulent fluid
• Quantity and character of fluid drained may allow early intervention
• Complications:
• Damage to surrounding tissues
• Infection
• Removal:
• As soon as possible
• When the drainage has stopped or became less than 25 ml/day
39. WOUND
• Wound dehiscence
• Disruption of any or all layers in a wound
• Around 5-8th POD after laparotomy
• Wound looks intact but the dressing is soaked with “Salmon Pink” colored fluid
• May need wound washout and re-suturing
• In some wound may be left open and treated with dressings or VAC pumps
• Evisceration is a catastrophic complication and may need emergency re-closure
• Re-operation for possible ventral hernia may be required but is not an emergency
40. CONTINUED…
• Fistula of GI tract
• Bowel contents leak out of a wound site or through drain site
• Fistulas not draining freely but leaking after a collection develops cause sepsis &
peritoneal irritation and require complete drainage
• Fistulas draining freely won’t cause peritoneal irritation or fever
• Potential problems due to fistula
• Fluid & electrolyte loss
• Nutritional depletion
• Digestion of abdominal wall
41. CONTINUED…
• Types of fistulas
• Low GI fistula (in distal colon) – up to 200-300 ml/day
• High GI fistula (in stomach, duodenum, upper jejunum – several liters per day
• Management
• Fluid & electrolyte replacement
• Nutritional support
• Protection of abdominal wall though suction tubes and ostomy bags
• Avoid the risk factors that prevent healing
• Keep the patient alive until the nature heals the fistula
42. CONTINUED…
• Pressure Sores
• Friction or persistent pressure on soft tissues in patients undergoing surgery for
prolonged periods of time
• Pressure points: Sacrum, Greater trochanter and Heels
• Prevention & Treatment
• Early mobilization and posture changes
• Air mattress for high risk patients
• W/W and W/D
43. WOUND CARE
• Within hours of surgical wound closure the dead space fills with inflammatory exudate
• Within 48 hours epidermal cell in wound edge bridge the gap
• Only inspect the wound if there is concern about its condition or the dressing needs
changing
• Infected wound or hematoma may require drainage and packing
• Send pus for culture & sensitivity (before giving antibiotics)
• Skin sutures or clips can be removed 6-10 days later or may be left longer in sutures
applied under tension
• Exclude factors that prevent healing
44. RECOVERY
• Factors that enhance recovery are
• Early physiotherapy and mobilization
• Earl oral intake
• Opioid sparing analgesia
• Support of nursing staff and community care providers
45. DISCHARGE LETTER
• Final diagnosis
• Treatment given
• Laboratory results
• Complications that might have occurred
• Discharge plan comprising of further care and management of complications,
physiotherapy and referrals for comorbidities
• Support needed by community care providers
• Follow-Up plan
• Prognosis (if appropriate)