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SDPA Fall 2016 Live Blog

SDPA Fall | Live Blog | Surgical Complications and Management

Dr. Lisa Chipps, MD highlighted common surgical complications and ways to manage these at the SDPA 14th Annual Fall Dermatology Conference. She stressed that smokers by far have the most problematic surgical complications, and urged that ALL health care providers discuss this subject with the patients for improvement healing post-surgically as well as for the overall improvement of the patient’s health.

Dr. Chipps uses the “HIS SAD” acronym (hematoma, infection, spitting suture, scars, allergic contact dermatitis, dehiscence) when identifying surgical complications.  Increasing pain 1-2 days after surgery could indicate the patient has a hematoma. Whenever a hematoma is identified, that patient is at an increased risk for infection and wound dehiscence.

Dr. Chipps states factors that may increase a patient’s risk for infection can include immunocompromised states, poor hygiene and a history of wound infections.  Reinforcing proper wound care is essential and use of a visiting nurse for older or immobile patients may be helpful.

Spitting sutures are most common weeks to months following a surgery and result from the placement of too much suture (throwing too many knots or leaving the tails too long).

Dr. Chipps shared many tips to help decrease the likelihood of causing scars including “do not overtighten epidermal sutures”. In the end, it is important to keep in mind that when helping patients with their scars, that it is a “process”.  She affirmed that all ablative lasers will help improve surgical scars.

Presentation of allergic contact dermatitis typically occurs 7 days post-surgery and is most often to adhesive or topical antibiotics.

Lastly, Dr. Chipps stated if you have a greater than 1-2% rate of wound dehiscence in your practice, you should consider your surgical technique as a possible cause.


Byline: Sarah Patton, PA-C, MSHS

Posted: November 2, 2016

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