Postoperative and Adjunctive Wound Care

Wounds are a major source of complications in surgery, but many can be avoided by using a sound, evidence-based approach to wound care. Preoperative considerations are discussed and include smoking cessation, glycemic control, weight loss, and adequate nutritional intake. Intraoperative considerations are presented and include proper classification of surgical wounds, hyperoxia and warming, and fascia closure techniques. Postoperative considerations that are presented include recognizing both early and late fascia complications, understanding skin closure techniques, and using adjuncts to postoperative wound management.  This review contains 7 figures, 24 tables, and 67 references. Keywords: Surgical site infection, infection, closure, suture, negative pressure wound therapy, open abdomen, mesh, surgery, granulation tissue