Question

Scenario: Bernie is a 70 year old man who had surgery to remove a connective tissue tumour under the skin of his right wrist. Three days after the operation, the nurse who examined Bernie's surgical wound observed that his hand, wrist and distal forearm are inflamed and there is a small amount of purulent discharge oozing from the wound. Bernie tells the nurse that the area around his wrist has become increasingly painful (there was general soreness following the operation) and increasingly difficult to gently bend his fingers at the knuckles and then straighten them. A wound swab is collected for a suspected surgical site infection.

Explain what has happened during the past three days to cause the signs and symptoms of inflammation and localised infection that Bernie is experiencing? including the structure of the skin and its function as a barrier defence that has been affected by the surgical incision, and the inflammatory response.

Answer 1

Bernie is experiencing signs and symptoms of inflammation and infection as a result of the body's immune response to the surgical incision. The disruption of the skin barrier allows bacteria to enter the wound, triggering an intense immune response. Laboratory analysis of the wound swab will help identify the specific bacteria causing the infection.

Step-by-step explanation:

The signs and symptoms of inflammation and localized infection that Bernie is experiencing are a result of the body's inflammatory response to the surgical incision. The surgical incision disrupts the skin, which is the body's first line of defense against infection. In response to the injury, the body releases chemicals called cytokines and histamines, which cause blood vessels to become more permeable, allowing fluid and immune cells to enter the tissue. This leads to swelling, redness, and heat in the affected area.

In the case of Bernie's infected wound, the presence of bacteria in the wound triggers a more intense immune response. The bacteria release pro-inflammatory molecules, which further increase the permeability of blood vessels and attract more immune cells to the site of infection. The accumulation of immune cells can lead to the formation of pus and the development of pain and increased difficulty in moving the affected area.

The wound swab collected from Bernie's wound is sent for laboratory analysis to identify the specific bacteria causing the infection and to determine the appropriate antibiotic treatment.