Wound Dehiscence Following Abdominal Hysterectomy: A Case Study

This case study focuses on Sarah Victor, a 51-year-old patient readmitted with wound dehiscence following an abdominal hysterectomy. The report defines wound dehiscence and discusses the physiological and biochemical processes of normal wound healing in the context of Sarah's case. A holistic assessment identifies factors affecting optimal wound healing, such as age, nutrition, and skin moisture. The study also addresses the psychosocial impacts of the wound on Sarah's daily life, comfort, and pain management strategies, along with documentation methods. Finally, it outlines strategies to minimize cross-infection, prevent disease spread, and reduce further complications, including the importance of an interdisciplinary team and products like Dermlin to promote healing. The report emphasizes a comprehensive approach to wound care, considering both medical and psychological aspects to enhance patient outcomes.

Running head: ABDOMINAL HYSTERECTOMY 1
Abdominal Hysterectomy
Name
Institutional Affiliation

ABDOMINAL HYSTERECTOMY 2
Abdominal hysterectomy
A patient with abdominal hysterectomy usually has the cervix, uterus, or both of the
organs removed through the abdomen itself. The outcome of this would either be vertical or
horizontal midline incision, depending on the approach of the surgeon and the size of the area
being treated. The surgeon may have to choose to either remove all or just part of the uterus
depending on the reason for the hysterectomy. When both the both tubes, both ovaries and the
entire uterus are removed the entire process is referred to as hysterectomy.
1.
Wound dehiscence refers to the condition where a wound partially or completely opens
up along the sutures to create a new wound (Anuj Gupta, 2010). Wound dehiscence can have a
great impact on the patient and requires readmission, surgical interventions or administering
antibiotics.
2.
Wound healing follow four process; Haemostasis, inflammation, prolifection, and
maturation. The processes is linear, however there is a possibility of the wound progressing
backwards (Yao, 2013). Haemostasis stage; the process happens very quickly and it begins due
to blood leaking out of the body and the construction of the blood vessels aimed at restricting the
blood flow. Then the sticking of the platelets helps in sealing the break in the wall of the blood
vessel. Finally, blood clots occurs and reinforces the platelet plug through the threads of fibrin.
The clot formulation keeps the platelets as well as the cells trapped in the wound as pointed out
by Ling (2014).

ABDOMINAL HYSTERECTOMY 3
(3) Wound healing may not be a smooth path; the process of healing may progress forward
or backwards depending on several outside factors. Looking into Sarah’s case her wound is sore
and smelly even after taking the prescribed antibiotics; this is clear indication that her wound is
not healed. Sarah’s wound may take long to heal considering her age. Age influences and affects
everything in one’s body including the structure and operation of the skin. During the aging
process everything slows down including the stages of wound healing. This may be Sarah’s case
since she is 51 years old. As one gets older the skin becomes thinner and the body show
decreased inflammatory response therefore leading to exposure to injury hence slowing the
healing process.
Sarah should check on her diet and ensure she takes nutritious food since
nutrition is vital to optimal healing. Lack of proper nutrients does not favor cell repair and
growth. Sarah should also observe her body weight since anybody surpassing their ideal body
weight by 20% has higher risks of infection when a wound is healing. Another factor that can
affect optimal wound healing is Skin moisture. The Skin needs enough fluid and moisture in
order to be viable. As in Sarah’s case older people are inclined to dry skin which puts them at
risk of skin injuries, infections and thickening and this impairs wound healing. A person
suffering from chronic conditions and has a wound may have a slower rate of healing their
wound, since this condition has a direct impact on the body’s natural ability to heal. Repeated
trauma is another case that slower the healing of the wound. If a patient has undergone severe
trauma the body’s fighting mechanism is limited and the wound heals slowly.
Wounds and wound healing are purely considered as medical phenomena, thou there is
growing evidence that the psychological effect on the patient is of equal significance (DiPietro,
2010). Psychological consequences of having a wound may include, stress, and sleep

ABDOMINAL HYSTERECTOMY 4
disturbance. These outcomes may be as a result of the physical effect of the wound. (Ling Na,
2017) This would affect the day to day activities of the patient since a stressed person may not be
able to give out their full potential even at their work place and this too applies to a person who
undergoes sleep disturbances since during work hours they may feel sleepy leading to poor
productivity in the work place and this may even lead dismissal from the work place which may
have a great impact in an individual’s life.
(4) Management of postoperative pain and torment eradicates suffering and leads to earlier
mobilization, few day in healing center, reduced hospital costs, and increased patient satisfaction
and fulfillment. (Anuj Gupta, 2010) Postoperative management isn’t a standardized
administration but focuses to the needs of the patients. Considering factors such as age, level of
fear or uneasiness, surgical strategy, individual preference and response to helpful agent’s
administered. For Sarah to manage the pain, she should minimize the medication dose to lessen
side effects. There is great need for pain control as it is helpful and humanitarian need of every
surgical strategy. Lack of adequate pain control may result to increased mortality. Factors that
may contribute to compelling postoperative pain management incorporate: acute management
team, patient education, and customary staff preparation and training.
(5) Prevention of surgical site infections includes meticulous operative procedure,
timely administration of necessary preoperative antibiotics and appropriate preventive measures
pointed at neutralizing the risk of bacterial, viral and fungal contamination brought
approximately by operative staff, operative room environment and the patients endogenous skin
flora. To minimize more infections Sarah should consider the above.

ABDOMINAL HYSTERECTOMY 5
(6) The practice of interdisciplinary team is important in specialized wellbeing care
setting. An interdisciplinary approach includes group individuals from distinctive disciplines
working together for a common goal. In Sarah’s case, the interdisciplinary teams include;
 Team of clinician may come in and help her on ways that would facilitate her wound
healing.
 Sarah’s family members may also contribute greatly to ensure her healing is faster, by
providing nutritious food which would aid her healing.
 The care group needs to combine efforts, utilizing the intrigue approach in order to be
able to meet the patient’s goals and needs. The interdisciplinary team ensures that the
team members have clear goals which are well understood. They participate in joint
evaluation, diagnosis and objective setting; they promote team cohesiveness and
inventiveness through group commitment.
 Friends are also essential for motivation in the treatment process
(7) For difficult wound treatment to be successful, the entire assessment of the patient
should be conducted. For a wound to heal adequate nutrition should be ensured, this is often
overlooked but it is very important for normal wound healing. Dermlin is one of the products
used and caters for wound healing. It is a wound recuperating dressing product affirmed
clinically by world renowned clinicians for quick mending of wounds. It absorbs exudations
from the wound and this helps prevent secondary infections, stimulating the expansion of human
epithelial cells, resulting in quick healing and less scar formation.
Conclusion

ABDOMINAL HYSTERECTOMY 6
Product such as dermlin would help Sarah in the healing of her wound. There has been
expanded experimental prove suggestive of an impeded response by maturing cells stretch. It
takes a dynamic process for a wound to heal. Normal wound healing occurs in a precisely and
timely manner.
References
Anuj Gupta, . K. (2010). Clinical aspects of acute post-operative pain management & its
assessment. PMC US national library of medicine, pp. 97-108.
DiPietro S. G. (2010). Factors Affecting Wound Healing. US National Library of Medicine , pp.
219-229.
Ling, P. a. (2017). Psychosocial Well-Being Associated With Activity of Daily Living Stages
Among Community-Dwelling Older Adults. US National library of medicine.

ABDOMINAL HYSTERECTOMY 7
Yao, K. (2013). Post-operative wound management. Australian Family Physician, pp. 867-870.