QLexNursing

✅ Increasing wound size (from 2 × 2 cm to 3 × 2 cm)

🔶 Wound vac therapy should promote shrinkage and granulation; enlargement indicates poor healing.

🔶 Increased wound dimensions suggest the wound environment is not optimized for repair.

🔶 A wound that grows over time can indicate infection or inadequate suction.

🔶 Healing progression is measured by consistent reduction in size, which did not occur.

🔶 Size increase signals the need to reassess the treatment plan.

✅ Increased pain from 4/10 to 8/10 with no relief from medication

🔶 Rising pain often reflects worsening inflammation or infection in the wound bed.

🔶 Lack of relief with medication indicates progression rather than expected postoperative discomfort.

🔶 Pain that intensifies a week after surgery is abnormal and concerning.

🔶 Pain escalation often precedes visible infection signs.

🔶 This trend should prompt immediate reassessment of wound integrity and therapy effectiveness.

✅ Development of purulent drainage

🔶 Purulent drainage indicates infection, which contradicts the expected outcomes of wound vac therapy.

🔶 Infection prevents wound contraction and granulation, delaying healing.

🔶 Wound vacs should reduce exudate and bacterial load, not worsen it.

🔶 Purulence signals bacterial activity overwhelming wound defenses.

🔶 This is one of the most definitive signs that therapy is unsuccessful.

✅ Temperature increase from 37.1°C → 38.6°C

🔶 Fever indicates systemic response to infection, commonly originating from the wound site.

🔶 Wound vac therapy should reduce bioburden; systemic infection shows the opposite trend.

🔶 Rising temperature aligns with the presence of purulence and uncontrolled wound inflammation.

🔶 This finding requires immediate provider notification.

🔶 Fever plus local signs confirm therapy failure.

✅ Heart rate increase from 94 → 104/min

🔶 Tachycardia is a physiologic sign of infection or uncontrolled pain.

🔶 Increased heart rate is consistent with systemic inflammatory response syndrome (SIRS).

🔶 A rising pulse in a post-surgical client indicates deteriorating status, not improvement.

🔶 Wound vac therapy should stabilize or improve vitals, not worsen them.

🔶 This change supports the pattern of infection.