Surgical incision and drainage + debridement and irrigation is a highly complex surgical procedure associated with various complications. If performed incorrectly, the procedure may cause negative consequences for the patient and the clinical outcome. A definitive diagnosis that may imply the application of surgical incision & drainage + debridement & irrigation is necrotizing soft tissue infection. In this case, the procedure might cause harmful complications, such as sepsis. This paper aims to discuss sepsis while addressing the incidence, pathophysiology, risk factors, signs and symptoms, diagnostic evaluation, and management of the complication. Sepsis is a severe medical issue that can lead to dangerous consequences if not treated properly.
As it is known, sepsis is related to the spread of infection by the bloodstream. The annual incidence of the illness in the United States is estimated to be up to 300 clinical cases per 100,000 people, and it is associated with high rates of mortality and morbidity2. The pathophysiology of sepsis was described in 1914, stating that sepsis occurs when “a focus has developed from which pathogenic bacteria, constantly or periodically, invade the bloodstream in such a way that this causes subjective and objective symptoms.”2 Furthermore, the risk factors of sepsis are associated with diabetes and the previous history of various infections2. Invoking the illness as a result of the surgical procedure may cause severe dangers for the patient.
There is a wide range of different symptoms that sepsis can cause. These include increased heart rate, rapid breathing, severe pain or feeling of discomfort, breath issues, confused or disoriented state, fever, shivering, and cold1. The first indicator for the diagnosis of the illness is systolic blood pressure, but the evidence from recent studies suggests that a practical biomarker that can be used for early diagnosis is procalcitonin1. However, the researchers believe that the nature of the infection may vary, provoking different levels of the inflammatory response, which can directly impact the severity of the illness2. To manage sepsis, clinicians use various immunomodulatory agents, primarily glucocorticoids. They help contain inflammatory and coagulatory adverse effects while also preserving their benefits.
Overall, surgical incision and drainage + debridement and irrigation is a highly complex procedure, especially when treating a patient with necrotizing soft tissue infection. The procedure under discussion has several complications, such as sepsis. Sepsis is a severe illness associated with many dangerous symptoms, meaning that, if left unattended or untreated, it can cause significant negative consequences for the patient. However, sepsis is a well-explored disease, and there are effective methods of managing that complication if it appears after the surgical procedure of incision, drainage, debridement, and irrigation.
References
Calsavara A J, Nobre V, Barichello T, Teixeira A L. Post-sepsis cognitive impairment and associated risk factors: A systematic review. Australian Critical Care, 2018;31(4):242-253.
Gyawali B, Ramakrishna K, Dhamoon A S. Sepsis: The evolution in definition, pathophysiology, and management. SAGE open medicine, 2019;7:1-13.