The management of surgical wounds in a community setting

Many patients are now having minor surgical procedures carried out in the community and those patients who undergo surgery in hospital are likely to be discharged earlier due to increasing pressure on hospital beds. This article discusses the management of surgical wounds healing by both primary and secondary closure, in the community setting. Understanding the complex process of wound healing is essential if nurses are to recognize abnormalities and select appropriate treatments for patients. The stages of wound healing will be discussed in detail, including the patient's presentation. Factors that influence this process within the patient (e.g. age, nutrition, medication and pain) and those at the wound bed (e.g. exudate, tissue type and infection) will be highlighted. Choosing the correct type of surgical wound dressing for the type of wound can contribute to wound healing, patient comfort and the cost-effectiveness of treatment. Factors that need to be taken into consideration when choosing a dressing will be outlined and suggestions made for the type of dressings that would be most appropriate. The importance of accurate and detailed documentation will be highlighted as part of this process.