Surgical Site Infection Diagnosis
The patient presents with signs and symptoms indicative of a surgical site infection (SSI) four days after open hernia surgery. Key indicators include:
- Fever (systemic sign of infection)
- Operated site being "wet with pus" (purulent discharge)
- Surrounding redness and edema (local inflammatory signs)
Appropriate Management Strategy
For a superficial incisional SSI with evident pus collection, the immediate priority is to drain the accumulated pus and allow the wound to heal by secondary intention or with appropriate wound care.
The most appropriate management involves:
- Opening sutures: This allows for the release of trapped pus.
- Cleaning of wound: Thoroughly cleaning the wound removes pus and debris.
While changing antibiotics (Option 1) and sending pus for culture and sensitivity (C/S) (Option 4) are important parts of managing an SSI, they are secondary to immediate source control via drainage. Daily dressing (Option 2) is a component of wound care but does not address the primary need for pus evacuation.
Therefore, opening the sutures and cleaning the wound is the crucial first step.
Important Questions from Pre-operative & Post-operative Care
- A surgeon is about to start a laparoscopic procedure on a patient. The floor nurse asks the surgeon about the identity of the patient, site of the procedure to be performed and any anticipated critical events during the surgery. These questions are a part of the
- Perioperative benefit from transfusion is with a haemoglobin level of
- A 60 year old lady underwent total abdominal hysterectomy. On the 3rd post operative day she suddenly became breathless while returning from washroom. Her blood pressure recorded was $80/50$ mm of Hg. The most probable diagnosis is
- Perioperative benefit from transfusion is with a haemoglobin level of
- Refeeding syndrome seen after enteral or parenteral nutrition is characterized by all EXCEPT:
