This Month's Focus: Post-Surgical Wounds
This month we're focusing on one of the most common consult categories we support across the continuum of care: post-surgical wounds, particularly surgical site infections (SSI) and dehiscence. Early identification and appropriate intervention can prevent avoidable complications, readmissions, and prolonged healing.

Case Spotlight: Distinguishing Delayed Healing from Infection
Setting: Post-acute, in-home care Consult type: Store-and-forward

A 40-year-old female presented with wound care concerns following an abdominoplasty performed in early December 2025. Two weeks prior to consultation, she developed a minor surgical dehiscence over the left hip along with seromas.

Wound measurement: 8mm x 5mm x 5mm, with minimal tunneling
Stagnant healing despite Medihoney and an ABD pad under a compression garment
Ultrasound showed no drainable fluid collections; CT scan pending
No systemic signs of infection
Clinical review and recommendations: The team confirmed superficial dehiscence without overt infection, recommended modifying topical therapy to optimize moisture balance and antimicrobial coverage, provided education on early SSI warning signs, and recommended close photo monitoring with a defined follow-up timeline.

"Virtual specialty review helped differentiate delayed healing from infection, preventing unnecessary antibiotic escalation or ED evaluation while ensuring appropriate surveillance."

SSI vs. Normal Post-Op Healing: What to Watch For
Concerning signs:

Increasing erythema extending more than 2cm beyond the incision
Purulent drainage
Escalating pain
Fever or systemic symptoms
Rapid wound deterioration
Expected post-op findings:

Mild localized erythema
Serous drainage
Minimal edge separation
Stable or improving measurements
SSI Risk Factor Checklist
Patients at higher risk for surgical site infection often have one or more of the following:

Diabetes or poor glycemic control
Obesity (BMI >30)
Smoking or nicotine exposure
Immunosuppression or steroid use
Malnutrition or low albumin
Prolonged operative time
Hematoma or seroma formation
Poor perfusion or vascular disease
Early excessive activity or incision stress
Clinical tip: Patients with multiple risk factors benefit from earlier post-op wound surveillance and a lower threshold for specialty consultation.

Common Mistake: Assuming All Wound Separation Means Infection
Not all dehiscence is infectious. Common contributors include mechanical tension at the incision line, seroma or hematoma formation, shear forces, obesity, diabetes, and premature activity. Initiating antibiotics prematurely without clear clinical indicators can increase resistance risk, delay correction of mechanical causes, and mask evolving symptoms.

Myth: "Surgical wounds always require in-person specialty care to manage safely." Reality: Many post-surgical wounds — including superficial dehiscence and early SSI concerns — can be accurately assessed and managed virtually when high-quality imaging and measurements are available. Early expert input often prevents progression.

When to Consider a Corstrata Consult
New or worsening surgical wound separation
Concerns for SSI
Stalled healing
Post-op complications
Uncertainty about escalation vs. conservative management
Transitions of care remain the highest-risk period for missed SSI and dehiscence progression.

Clinical Pearl
Surgical wound complications most frequently emerge 7–21 days post-op. Consistent photo documentation and early specialty review during this window significantly reduce avoidable ED visits, unnecessary readmissions, and delays in intervention.

Where Corstrata Fits
The Corstrata clinical team provides virtual wound and ostomy expertise across the continuum of care, routinely supporting surgical wound management in:

Acute Care — early post-op assessment and SSI differentiation
Hospital at Home — real-time wound surveillance and complication prevention
Post-Acute & SNFs — treatment optimization and escalation guidance
Home Health — monitoring healing trajectory and preventing avoidable utilization
TEAM (Transforming Episode Accountability Model) Hospitals — preventing wound complications in 30-day surgical bundles
Consults are available via store-and-forward wound images or live video.

Have a patient with a wound that isn't tracking as expected? Reach out to your Corstrata clinical team for a virtual specialty review.