Dealing with Cellulitis Abscess after Surgery and Nursing Diagnosis

Abscesses can quickly arise for and after surgery. Abdominal surgery of the biliary and digestive tract is especially prone toward abscesses and sepsis because if the peritoneum becomes contaminated the risk after increases. Also, if you sustain a traumatic injury, that causes hematomas or lacerations of the intestines, pancreas, spleen, or liver. The bowel often becomes the infecting organism because of its thriving colony of aerobic and anaerobic bacteria or flora. The most common cause if abscesses and infection include:

  • Aerobic gram-negative bacilli (Klebsiella and Escherichia coli)
  • Anaerobes such as the Bacteroides fragilis

Understanding Cellulitis After Surgery

A surgical incision is a ripe breeding ground for bacteria. Cellulitis after surgery is a common occurrence, especially in the elderly or individuals with a compromised immune system. Please look over the pictures.

What is a Cellulitis Abscess

An abscess develops as a hard, firm lump filled with pus. Eventually, it will come to a head and burst. Once it spews its purulency, then the crater-like hole becomes ripe for a severe bacterial infection and cellulitis.

A cellulitis abscess is a painful situation that requires prompt medical care.

Abdominal Abscesses After Surgery

Intra-abdominal abscesses are a frightening reality that has become all too common. They are usually classified as:

  • Intraperitoneal
  • Retroperitoneal
  • Visceral

The abscess can rupture and form a genitourinary fistula. Subdiaphragmatic abscesses can become severe extending into the thoracic cavity and leading to limb abscesses, empyema, and pneumonia. Abscesses that develop in the lower abdomen can emerge on the thigh a perirectal fossa. The mortality rate for abdominal abscesses can reach up to 40 percent. Virtually all abscesses of such a degree require surgical drainage.

Boils, Abscesses, and Cellulitis

Boils emerge as penny sized bumps that are extremely painful. Abscesses are greater in diameter. Both fill with pus and reach into the deep layers of the skin. Abscesses and boils both pop and drain fluid. After the lesions erupt like a volcano, cellulitis can rapidly develop. Staph and strep cause boils, abscesses, and cellulitis. The bacteria naturally thrive on the skin’s surface but rapidly invade when a break occurs. However, unsanitary living conditions and personal hygiene can make the infection more prevalent. Methicillin-resistant Staphylococcus aureus (MRSA) is becoming a scary and common problem. Skin infections that arise from MRSA are contagious. In addition, researchers have found that people carry the bacteria in their nose and throat which they can pass on to other peoples’ wounds.

Blood Septicemia

Blood septicemia (sepsis or blood poisoning) is a life-threatening complication of cellulitis, boils, and abscesses. Left untreated, the infection rapidly spreads to all the body’s organs and the heart’s valves. Within a short time period, the afflicted person’s entire system will shut down and death becomes imminent. At least 50 percent of all cases prove fatal.

Additional complications of pyemia include:

  • Blood clots
  • Complete organ failure that requires life support or prompt surgical intervention.
  • Widespread tissue death (referred to as gangrene). They must remove the dead tissue and sometimes, it requires complete amputation.

Understanding the Complications of Cellulitis

Whether you have sustained an injury or underwent surgery, you still could develop a secondary infection. Complications of cellulitis are no laughing matter. They can prove deadly without proper care. Widespread tissue damage and death. The infection can enter the bloodstream travel to the bones, nervous system, heart, and lymph nodes. Within a relatively short span of time, the situation can become unstable, amputations are a reality, and in some situations death.

The Nursing Diagnosis for Cellulitis

Cellulitis might not be communicable but it spreads rapidly through a person’s system. There is non-necrotizing inflammation that involves not only the skin but also the subcutaneous tissues. The area appears inflamed, red and painful. Nursing diagnosis for cellulitis is:

  • Blood Tests: They obtain blood to run pathology testing for systemic and blood infection.
  • Wound culture: A wound culture renders the causative factor.
  • Ultrasound: They use an ultrasound to detect any abscesses. This is critical after abdominal surgeries Abscesses to mouth are found via CAT scan and abscesses to face can be detected with similar radiological testing.

Management Includes:

  • Antibiotic therapy is ongoing for at least 10 to 21 days.
  • Drainage of any abscesses.
  • Rest is imperative for a full recovery. Always make sure they place the infected area at a higher elevation than the heart to control edema.
  • Amputation of extremities might become gangrenous. They must remove the entire member to halt the necrotic spread.

Nursing care:

  • Monitor healing of the wound.
  • Ensure the patient has optimum nutrition
  • Continue treatment plan
  • Keep the patient’s spirits high by increasing self-esteem
  • Continue getting and securing specimens from the drainage wounds for laboratory analysis.
  • Watch for complications and stay vigilant of wound healing progression
  • Keep the wound clean and dry at all times. You must always apply the dressings in such a fashion that the body’s natural repair process can take over.
  • Only use barrier dressings to protect the wound.

Optimum nursing care is the front line for recovery. Nurses are in charge of the care, triage, and aftercare of anyone suffering severe cellulitis, abscesses, or boils. Whether in the hospital or at-home nursing practices are similar when caring for cellulitis.

 

 

Article References:

  1. https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/intra-abdominal-abscesses
  2. https://www.hopkinsmedicine.org/health/conditions-and-diseases/intraabdominal-abscess
  3. https://www.hopkinsmedicine.org/health/conditions-and-diseases/cellulitis
  4. http://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/dxc-20169787
  5. https://nurseslabs.com/dermatitis-nursing-care-plans/
  6. https://nurseslabs.com/cellulitis/

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