Question

Your 45-year-old patient was readmitted after very long abdominal surgery two weeks prior. She went home and stated she followed the discharge instructions. Yet, upon your initial assessment, you find redness at the wound site and around the site, little bleeding but a discharge with a foul odor, and the patient has a temperature of 100 degrees. Question: What stage of healing is the patient in? Explain your answer showing the stages of wound healing and what stage your patient is in.

Answer 1

Though the patient had been following the instructions after being discharged but still got redness around the wound with bleeding and foul discharge feom the wound and also fever. This is may be due to the complication of DEHISCENCE . Dehiscence may occur after 5 to 12 days after suturing when collagen synthesis is at its peak.

She followed all the instructions after getting discharge from hospital, but there may be some other factors which may caused wound dehiscence like diabetes,obesity, inadequate nutrition, infection and smoking. There may be reason like improper suturing.

Stages of wound healing-

Stage 1 -hemostasis stage- it immediately starts and forms blood clot due to aggregation of platelets and collagen.

Stage 2- inflammatory phase-in this neutrophils comes and remove the debris about 24 to 48 hrs after injury and reduce in number after 3 days.

Stage 3- proliferative phase-3 things occur during this stage- 1. Filling of the wound.2.contraction of the wound margin. 3.covering of the wound.

This stage lasts for 4 to 24 days.

Our patient was in this stage

In this stage new blood vessels are formed and the wound is filled with new granulation tissue.

Stage 4- maturation stage- it lasts from 21 days to years

In this tensile strength is increased.

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