IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 4 Ser. 12 (April. 2019), PP 60-62 www.iosrjournals.org DOI: 10.9790/0853-1804126062 www.iosrjournals.org 60 | Page Management of Postoperative Wound in Neurosurgery Department of RIMS, A Single Centre Experience Dr Alok Chandra Prakash(1), Dr Anand Prakash(2) 1-Senior Resident,2-Associate Professor Department of Neurosurgery RIMS Ranchi Jharkhand India Corresponding Author: Dr Alok Chandra Prakash Abstract: Post operative woundhealing problems in the neurosurgical patient can be particularly bothersome, owing to various specific risk factors involved. These may vary from simple wound dehiscence to complex multilayer defects with cerebrospinal fluid (CSF) leakage and contamination. The latter is quite rare in practice and requires an individually titrated reconstruction strategy Optimal management of postoperative wounds in the wards is important to prevent potential complications such as surgicalsite infections and wound dehiscence from developing. As such, Resident doctors, who play an important part in the subacute management of postoperative wounds, should appreciate the physiology of wound healing and the principles of postoperative wound care. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 04-04-2019 Date of acceptance: 19-04-2019 --------------------------------------------------------------------------------------------------------------------------------------- I. Objective The objective of this article is to update Resident doctors on the important aspects of post-operative wound care. This includes a review of the physiology behind wound healing, an update on wound cleansing and dressing methods, as well as a guide on how common postoperative wound complications should be managed. II. Discussion The key elements of postoperative wound care include timely review of the wound, appropriate cleansing and dressing, as well as early recognition and active treatment of wound complications. Appropriate post-operative surgical wound care is essential in preventing potential complications, such as surgical-site infections (SSIs), wound dehiscence and haematomas. Resident Doctors play a major role in managing patients’ postoperative wounds in the wards and it is important to appreciate the principles of postoperative wound management to minimise the incidence of wound complications. Phases of wound healing Wound healing has classically been described to occur in three phases, regardless of the mechanism of injury. These phases are the inflammatory, the proliferative and the remodelling phases.1–3 The inflammatory phase is the body’s natural response to injury and takes place immediately after the wound is formed. The wounding triggers a localised release of inflammatory mediators that encourage vasodilation. Increased blood flow to the region then results in an influx of phagocytic leucocytes, such as neutrophils and macrophages, which play a key part in digesting bacteria and autolysing devitalised tissue. The inflammatory phase of wound healing is responsible for the classical signs of inflammation that occur in response to an injury: erythema, heat, oedema, pain and decreased function. The wound starts to rebuild itself in the proliferative phase. Granulation tissue, comprising collagen and extracellular matrix, fills the wound defect and angiogenesis also occurs. As the wound defect fills, the wound gradually contracts and epithelial tissue begins to form at the wound edges. Eventually, complete epithelialisation happens, with epithelial cells fully resurfacing the wound. The final stage of wound healing is remodelling, which occurs once the wound is closed. In this phase, the wound regains its tensile strength as the collagen fibres within the wound remodel and reorganise themselves. It is also during this phase that the wound devascularises and returns to its original state of blood supply. Types of wound healing There are two main types of wound healing: primary healing and secondary healing. Most surgical wounds undergo primary closure in which there is minimal tissue loss and the wound edges can be satisfactorily