Enf. Miguel Casimiro

Outpatient Consultation

Prevention of infection in surgical wounds

HPA Magazine 21 // 2024

Currently, the growth in the number of surgeries is evident in almost every medical specialty. This is not only due to the increase in life expectancy, where comorbidities to be treated may manifest in greater numbers, but also due to the advancement of scientific knowledge, which makes it possible to treat more pathologies with a higher success rate. 
With the development of healthcare, it is possible for the patient to have a faster recovery, reducing their hospitalization period and associated comorbidities, promoting their autonomy and a quicker return home to be with their family. To achieve this, the provision of nursing care becomes fundamental, aiming at promoting the patient's autonomy. From this perspective, the Regulation of the Professional Practice of the Nurse, approved by Decree-Law No. 161/96 of September 4, emphasizes in the first paragraph of the fourth article of chapter two that Nursing, as a profession, aims to help the human being achieve their maximum functionality as early as possible.

The surgical patient has various health risks inherent to the hospital environment. Among them, the risk of infection stands out. Despite all preventive measures, surgery always entails risks, including infectious risks. In this sense, it becomes crucial for the nurse to perform hand hygiene, use personal protective equipment, ensure the correct hygiene of surfaces and equipment used, carry out treatment for the surgical wound under aseptic technique, and possess knowledge to identify warning signs. Thus, it is possible to minimize the risk of infection and reduce potential complications in the patient.
In the outpatient clinic of the HPA Group, at the Gambelas unit, treatment for the surgical wound is an intervention performed by nurses. These professionals have scientific knowledge in maintaining and recovering the patient's skin integrity (paragraph c), point number four of the ninth article of chapter four of Decree-Law No. 161/96 of September 4. In this way, the principles of asepsis and manual dexterity, as well as the identification of inflammatory signs in the surgical wound, become crucial to anticipate repercussions in the patient.
There are five inflammatory signs: edema (swelling), erythema (redness), heat, pain, and loss of function. When one of these signs is observed in a surgical wound, it may indicate that something is not right. 
However, the presence of one of these signs alone does not unequivocally mean that the patient is developing or already has an infection. For example, edema is common after surgery. Therefore, observation and clinical expertise are important in distinguishing these factors.
 

Nursing interventions, as emphasized earlier, are fundamental in caring for the human being. Nevertheless, working in a multidisciplinary team is equally essential for comprehensive patient care. In this sense, the coordination of nursing interventions with other healthcare professionals becomes essential to meet the patient's needs. 
Particularly, working with the medical team is of utmost importance regarding communication of changes in the surgical wound. 
Thus, it is possible to proceed with joint care and prevent complications in the patient. It is known that, according to the Order of Nurses (2001), it is part of the nurse's role to refer identified situations considered potentially harmful to the patient to other professionals in the multidisciplinary team.
As HPA is a leading private healthcare in the Algarve, the pursuit of excellence in care is a daily concern of nursing professionals with a view to patient satisfaction. 
In this sense, the Order of Nurses (2001) emphasizes the duty of this role in nurses when stating that there should be a constant pursuit of excellence in the exercise of the profession.