Treating the Wound to Support Surgical Success

A well-managed surgical wound can make just as much difference as a procedure performed to the highest standard. Preventing complications does not end in the operating theatre; it continues throughout the post-operative period with increasingly advanced treatment protocols, innovative wound dressings and an active role for the patient in the healing process.

Dr Alessandra Saputelli, General Surgeon and Consultant at the General and Emergency Surgery Unit of the San Filippo Neri Hospital in Rome, explains the importance of proper wound management, particularly in emergency surgery.

«If we are dealing with what is classified as a ‘dirty’ procedure, such as one involving faecal or purulent peritonitis, wound management can have a significant impact on the risk of complications. In these cases, we use negative pressure wound therapy, known as PICO, which applies controlled negative pressure through a device connected to a dressing that can cover wounds measuring 20, 30 or even 40 centimetres, depending on the length of the surgical incision».

Managing Surgical Wounds with Advanced Dressings

Dr Saputelli specialises primarily in abdominal wall and emergency surgery, treating umbilical and inguinal hernias as well as incisional hernias using both laparoscopic and open surgical techniques.

Within this context, surgical wound management represents a crucial stage of the patient’s recovery, particularly following complex or contaminated procedures.

Advances in wound care are not limited to negative pressure therapy. A range of innovative dressings is now available to manage wound exudate and promote healing, even in particularly challenging cases.

«Hydrofibre dressings enhanced with carboxymethylcellulose are extremely important because they absorb wound exudate, significantly reducing the risk of fluid accumulation within the wound – explains Dr Saputelli – Silver alginate dressings are equally valuable due to their antimicrobial properties, particularly for fibrinous, bleeding or cavity wounds where fluid has already begun to drain from the wound. These materials can be used to fill the cavity, helping to reduce wound secretions and support the healing process».

From Traditional Methods to a More Advanced Approach

Where post-operative care once relied mainly on wound disinfection and simple gauze dressings, today’s treatment options have evolved considerably.

«The use of negative pressure therapy and modern advanced wound dressings has reduced complications, improved patient compliance and enhanced wound healing overall. We see fewer wound secretions and a lower incidence of wound dehiscence», says Dr Saputelli.

The effectiveness of these advanced treatments also depends on appropriate care once the patient returns home. For this reason, patient education is an essential part of post-operative recovery.

«Patients receive guidance from both surgeons and nursing staff on how to manage their dressings correctly. When negative pressure wound therapy is used, we explain how the device works and why it is essential not to interrupt its operation – Dr Saputelli explains – The dressing consists of a protective covering applied over the wound, connected via tubing to a vacuum device that generates a gentle level of negative pressure compared with that used for open abdomen therapy».

Beyond learning how to use the device correctly, patients are also taught how to recognise potential warning signs that may indicate the dressing needs to be replaced.

«This applies to all types of advanced wound dressings. Whenever the patient is able to participate actively in their care, we always explain why these dressings are important and what they should do if they notice that the dressing has become soiled or compromised».