What are the key postoperative care strategies to prevent complications such as infection and thromboembolism?

Key postoperative care strategies to prevent complications such as infection and thromboembolism include a combination of mechanical and pharmacological interventions, meticulous wound care, and early mobilisation.

To prevent thromboembolism: Mechanical prophylaxis with graduated anti-embolism stockings or intermittent pneumatic compression devices should be started on admission and continued until the patient regains normal or anticipated mobility. Stockings must be properly fitted, removed daily for skin inspection, and discontinued if skin damage or discomfort occurs, with alternatives offered if needed. Pharmacological prophylaxis with low-molecular-weight heparin (LMWH) or fondaparinux sodium is recommended for at least 7 days postoperatively in patients whose risk of venous thromboembolism (VTE) outweighs their bleeding risk, tailored to the type of surgery and patient factors. For major cancer surgeries, extended prophylaxis up to 28 days may be considered. Patients on oestrogen-containing therapies should be advised to stop these 4 weeks before elective surgery to reduce VTE risk. Early mobilisation and adequate hydration are essential nursing care components to further reduce VTE risk ¹.

To prevent surgical site infections (SSI): Use of antimicrobial triclosan-coated sutures is advised, especially in paediatric surgery, to reduce infection risk. Sutures are preferred over staples for skin closure after caesarean birth to reduce superficial wound dehiscence. Surgical incisions should be covered with appropriate interactive dressings at the end of the operation. Postoperative wound care requires aseptic non-touch technique for dressing changes, sterile saline for wound cleansing up to 48 hours post-surgery, and safe showering after 48 hours. Topical antimicrobial agents are not recommended for wounds healing by primary intention. Routine wound irrigation or intracavity lavage to reduce infection risk is not advised. Blood glucose control should be optimised in diabetic patients but routine insulin use in non-diabetics is not recommended solely to reduce SSI risk ².

Integrating these strategies, early mobilisation and hydration are critical to both infection and thromboembolism prevention, as supported by clinical literature emphasizing improved outcomes with such interventions in postoperative hip fracture management (Colón-Emeric, 2012).