••• CHAPTER 35^ Postoperative Care of the Gynecologic Patient^359
❍ What are the four stages of wound healing?
Inflammation
Epithelialization (migration)
Fibroplasia
Maturation
❍ What is the duration of each of these stages?
Inflammation: completed within 3 days in absence of infection.
Epithelialization: completed within 48 hours of surgery.
Fibroplasia: collagen production begins on 2nd post op day, maximum rate at 5 days post op and continues for at
least 6 weeks. Angiogenesis occurs during this stage.
Maturation: 80% or original tissue strength is restored by 6 weeks post op; appearance of normal skin at 180 days;
remodeling continues for years.
❍ What is the most common complication following myomectomy?
Fever, which may occur in up to 67% of patients. However, localizing symptoms are found in <15% of these
patients when the fever occurs within the first 48 hours and may be related to hematoma formation and release of
inflammatory markers from the uterine wall.
❍ How long after a myomectomy should a woman wait to conceive?
3 to 6 months.