Acute Surgical wounds
Picture of wound Wound Indicator/descriptor Management Aims Recommended Products Relevant links
May vary depending on surgeon
preference:
- Semi Permeable (e.g., op-
Prevent Infection
An acute clean surgical site, Tegaderm)
Simple post operative Assist healing
incision which will heal by - Island dressing (e.g.,
wound Keep wound edges
primary intention Primapore)
opposed
- Fixation Sheet (e.g., hyperfix)
Closed with sutures, staples,
steri strips or surgical glue.
A tract with an opening on
the skin leading to a
collection of hair, most Prevent further infection
Initially post operatively packed
commonly occurs in the natal Assist healing
Pilonidal sinus with an alginate dressing
cleft(in the midline between Allow drainage
Foam dressing (e.g., cavi care)
the buttocks) Can become Prevent build up
infected by bacteria, causing
pain and swelling
Transfer of split thickness
(most common) or full
Apply pressure to
thickness sheets of skin from Non adherent Moist Tulle Gras
achieve haemostasis
the donor site to a wound. Dressing impregnated with Kids Health Info -
Immobilise to promote
Skin grafts Skin graft may be meshed to antiseptics or antibiotics, such as
allow for drainage of exudate
healing
Bactigras Gauze Split Skin Grafts
Immobilise to reduce
and expansion of the graft, Crepe bandage
pain
or may be left as an intact
sheet
The Royal Children’s Hospital Melbourne April 2012
Alginate dressing (e.g.:
Kaltastat) - not suitable for
An area of the body where Promote healing
infants younger than 12 months
skins is taken to cover a Simple to change, with
or
debrided wound caused by minimal disruption to
Donor sites Aliginate Hydrocolloid (e.g.:
injury or burn. Common sites new epithelium
Duoderm)
of the donor area are the Patient comfort
Dressing choice will be
thigh, flank, and buttocks Increase healing rate
dependant of surgeons
preference
Synthetic fibre gauze, (Topper 8
An insertion point of a pin Prevent infection pre cut 5 x 5cm) Limb
from and external fixator Prevent hypertrophy of Foam Dressing, (Allevyn non Reconstruction (LR)
Pin sites through the skin& muscle to skin or tissue at the adhesive - for femurs)
hold the bone in a position, pinsite Absorbent Silver Barrier : Post-operative
or to move to a new position Patient comfort Dressing, (Allevyn Ag non management
adhesive -for infection)
A ventricular assist device
can support the left side,
right side or both sides of the Prevent wound
heart. It is for bridging to infection, promote
VAD Wounds Foam dressing (E.g., Mepilex)
transplantation, recovery and healing and patient
for patients unable to wean comfort.
from cardio-pulmonary
bypass
An incision made through Prevent wound
the skin and dura matter to infection. Improve
Post op Cranial
provide visibility patient comfort and Island Dressing (e.g., Primapore)
surgery
and access to any region of encourage the healing
the brain. process
The Royal Children’s Hospital Melbourne April 2012
The midline vertical Prevent wound
incision into or through the infection, promote
Sternotomy Island Dressing (e.g., Primapore)
sternum to provide access to healing and patient
the mediastinum comfort.
An incision through an
Prevent wound
intercostal space on the
infection, promote
Thoracotomy back. It is the common Island Dressing (e.g., Primapore)
healing and patient
approach for operations on
comfort.
the lung on posterior
Dressing choice will be
An opening between dependent on clinical
stomach and abdominal Maintenance of skin assessment and individual Gastrostomy-
Gastrostomy
surface either for integrity patient needs refer to common problems
decompression or feeding Gastrostomy Common Problems
Clinical Guideline
Dressing choice will be
dependent on clinical
A surgical opening into assessment and individual Tracheostomy
the trachea to relieve upper patient needs Clinical Guidelines
Maintenance of skin
Tracheostomy airway obstruction, support A stomal therapist and/or
mechanical ventilation or aid
integrity (Hospital) - Stoma
respiratory nurse will be involved in Care
the removal of secretions
the management of new
tracheostomies
The Royal Children’s Hospital Melbourne April 2012
Product choice depends on
Fistula: an abnormal track clinical assessment including
can be internal or external amount of exudate and position
Stoma: artificially created Skin protection and Consider Ostomy appliances,
Stoma and fistulae
hole that connects an organ patient comfort Protective skin products,
to the outside Negative pressure wound
Nb; Both change regularly therapy, Absorbent dressings
and Foam dressings
Prevent wound
To drain blood, pleural fluid infection, promote
Pleural drains Drain swabs(Topper)
or evacuate air. healing and patient
comfort.
Drain swabs(Topper)
Prevent wound Nb, If leaking around tube excessive
Chest drains are required
Mediastinal Chest infection, promote
following cardiac surgery to drainage observed following
drains healing and patient
drain blood around the heart. removal please refer to Stomal
comfort.
Therapy
Surgical drains are used in a Dressing applied
wide variety of different types intraoperatively remain
of surgery. The intention is to intact until the drain is
decompress or drain fluid or removed, with the Gauze
Post operative wound
air from the area of surgery. exception of the Semi permeable dressing(e.g.,
drain
Examples include Penrose, Penrose drain which will Tegaderm)
Jackson Pratt, Redi vac, require dressing
Hemovac, Mini Vac and Pig changes to remove
Tail Drains drainage.
Note: All dressing choices should be dependent on clinical assessment and individual patient needs
The Royal Children’s Hospital Melbourne April 2012
