Nursing Priorities of Care for Post-Operative Wound Infection: A Case Study of Mrs. Gina Bacci

Nursing
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Introduction
The essay will describe Mrs. Gina Bacci’s case study. Mrs. Gina Bacci is a 49 years old
Italian lady who has poor English, she has a history of diabetes type II. She is obese with a BMI
of 40.4 m2. The diabetes got worse and she is therefore commenced on insulin on her admission.
She underwent surgery following her complications from a right foot ulcer. Mrs. Bacci
underwent the surgery under general anesthetic two weeks ago and this time around she has
presented to the hospital mobilizing with an offloading boot and walking stick. Mrs. Bacci
underwent some examination where the vital signs were taken. The post-surgical wound was
examined and the findings was that the wound had an island film dressing along the incisional
line which is wet from the serous exudate output. Dehiscence was also noted on the wound.
There is also some sloughy tissue. The skin surrounding the wound is warm, dark pink and
painful to touch. Mrs. Bucci was put under medication when she was going home after the
surgery, she was given some medication including; Novorapid, Lantus, Pregabalin, and
Paracetamol.
Underlying pathophysiology and causes of the post-operative wound status.
The state of Mrs. Bacci wound showed signs of infection. Therefore, the essay will discuss
the pathophysiology of postoperative surgical wound infection. An infected wound is a localized
or excavation of the skin or the underlying soft tissue (Edmonds & Foster, 2014). For the surgical
site to be infected it requires contamination on the surgical site by microbes. The microbes may
include fungi or bacteria. Wound infection can occur when the number of virulence
microorganisms overwhelms the natural body defense mechanism (Weiss, & Schaible, 2015).
Mrs. Bacci’s body immune system is then triggered resulting in inflammation, tissue damage as

well as a delay in wound healing. The microorganism causing infection must have an origin.
Other microbes originate indigenously such as from the patient’s skin while others may originate
from exogenous sources such as microbes from the surgical cutting instruments, from the
healthcare team members and from the air as well. Therefore, virulence microbes normally injure
the intact skin that surrounds the incision site and which has viable tissues. The injured tissues
release chemicals including histamine, bradykinin, and prostaglandins (Harper, Young, &
McNaught, 2014). Some of the released chemicals cause the blood vessels to leak fluids into the
tissues causing the swelling and inflammation. The released prostaglandins lead to pain around
the incision site. When the inflammation has occurred white blood cells also produce chemicals
then release them to the infected tissue or the blood as a way of immune response, however, this
increases blood flow to the infected tissue resulting into the readiness and the increased warmth
(Sompayrac, 2019)
From the Mrs. Bacci case scenario, the following characteristics were observed from her
post-surgical wound; island film dressing along with the incisional line, wet dressing from the
serous exudate showing that the wound is oozing. The wound also has some dehiscence along
the suture line, it has a sloughing tissue, the skin surrounding the wound is warm and dark pink
in color. Exudate is an inflammatory liquid leaking between cells and which has been filtered
from the circulatory system into the areas of inflammation (Nash, Dalziel, & Fitzgerald, 2015).
Exudate plays an important role in wound healing. During wound healing, the exudate provides
moist wound bed. The exudate supplies the necessary nutrients required for quick wound
healing. Normal serous exudate can indicate the progressive wound healing whereas abnormal or
purulent effluent serous exudate normally yellow, grey or green in color shows invasion of an
infection in the surgical site.