The Impact of Nonwound Site Infection on Surgical Wound Healing

Abstract

When infection occurs at a surgical site, it is clear that the normal wound healing process is destroyed, interrupted or at best retarded. However, little is known about the effects of nonwound site infections on the healing process. One concern is that the level of cytokine tumour necrosis factor-alpha (TNFα) produced in the inflammatory process of the infection will have a detrimental effect on the wound healing process. Another concern is that the negative clinical manifestations of sepsis on the maintenance of homeostasis are augmented by the effects of general anesthetic agents used in surgery. Therefore, if the infection is not minor and has the potential for systemic spread, it is best to defer surgery until the infection clears. However, in nonelective surgery, the candidacy of a surgical patient is more likely to be dependent on the clinical manifestations of the infection.