Case Study: Nursing Management of Surgical Wound Complications

Running head: CASE STUDY 1
Case Study
Student’s Name
University Affiliation

CASE STUDY 2
Case Study
There are several factors that may contribute or increase the chances of surgical wound
complications such as macro vascular and micro vascular disorders, age, obesity and
malnutrition most common to diabetic individuals (Tsourdi, Barthel, Rietzsch, Reichel &
Bornstein, 2013). This explains why best nursing care is required to patients with such
conditions.
This paper includes the case study of Mrs Bacci by critically discussing the underlying
pathophysiology and wound status of Mrs Bacci. Besides, the paper identifies the primary
nursing priorities of care and appropriate and safe nursing management for Mrs Bacci’s current
condition.
Based on the case study, there are several pathophysiology processes that Mrs Bacci is going
through. Such pathophysiological processes include a high blood pressure of 120/70mmHg and a
high reading temperature of 37.8 degrees Celsius. Besides, her feet and toes are cool to touch
with a capillary refill of two to three seconds.
She also seems to be having fever which makes her to feel cold. Besides, when assessed, her
pulse is 88 bpm regular, RR18bpm and SpO2 is 97percent on RA. Furthermore, when examined
by the doctor, her dressing wound was wet with some exudate output. The wound has some
dehiscence along the suture line and there is some sloughy tissue and the surrounding skin is
warm, dark pink and painful to touch.
The physiological effects that Gina is going through are as a result of the vascular and
inflammatory response. Also, the age of Gina and her history of having diabetes ii disorder,

CASE STUDY 3
obesity and peripheral vascular disease impact his condition by complicating the process of
surgical wound healing.
The vascular response process of a wound involves the process where the damaged ends of
the blood vessels constrict to limit or reduce the rate of blood flow and initiate the clotting
process. A blood clot which consists of a fibrin mesh is formed in the process. The function of
the blood clot is to trap the blood cells and seal the wound. Blood vessels surrounding the wound
also occur and other growth factors are released. The released growth factors are utilized in
attracting white blood cells and inflammatory stage chemicals. This process explains why Mrs
Bacci’s feet are cool to touch with a capillary refill of 2 to three seconds.
Inflammatory in wound healing involves an increase in blood flow and amassing of fluid
prompting to the development of delicate soft tissue around the injury as on account of Bacci.
The phase also involves signs of erythema, oedema and heat. Pain and restriction of movement
also occur which is as a result of exerted pressure on the sensory nerve. This explains why
Bacci’s wound is wet from exudate and her wound is painful when touched
Some people especially those with diabetes, those who sand smoke and have a condition that
affects the immune system have high chances of increased risk of wound infections. Like in this
case, Mrs Gina Bacci has a history of diabetes and her diabetes condition has been worsening.
Besides she has a history of peripheral vascular disease and obesity which weakens her immune
system (Gibbons & Shaw, 2012). This explains why Gina has been having complications in her
would after surgery. This history explains why Gina’s wound status is worsening thus the need
for more attention.

CASE STUDY 4
There are certain factors that may lead to the risk of postoperative wound complications
(Mills, 2017). These factors include the part of the body involved in the surgery, the type of
surgery and kinds of medications given. Other factors include the use of immunosuppressive
agents like prednisolone and methotrexate, tobacco smoking, peripheral vascular disorder, poorly
controlled diabetes and immunosuppressive disorders (Bertesteanu et al., 2014).
According to (Bertesteanu et al., 2014), immunosuppressive diseases and the use of
immunosuppressive agents like methotrexate restrain the inflammatory process thereby delaying
the process of wound healing. Besides poorly controlled diabetes is understood to impair the
initial inflammatory response and suppresses the function of neutrophil and phagocyte thereby
slowing down the process of wound healing. Furthermore, the peripheral vascular disorder is
known to inhibit the oxygen delivery to the tissue and poor nutrition is understood to slow down
the metabolic processes thereby reducing the rate of collagen synthesis. For these reasons, it is
important for the caring nurse to manage these factors to prevent surgical wound complications.
Basing on the facts from the case study on the condition of Mrs Gina Bacci’s wound; there
are several nursing priorities of care that an effective nurse is supposed to provide to the patient
for quick recovery. These priorities may include making sure the client to eats a balanced diet,
watching for infection, maintaining the normal elimination patterns of the wound and controlling
the pain of the client for a quick recovery. However there are many priorities a nurse will
prioritize on, the two main priorities include ensuring the client eats a balanced diet and watch
for infection.
First nutrition will be highly prioritized by a nurse based as a patient’s metabolic needs are
high. A nurse is supposed to ensure the electrolyte levels of Mrs Gina Bacci are balanced. Eating