Wound Dehiscence

Wound dehiscence is the parting of the layers of a surgical wound. Either the surface layers separate or the whole wound splits open. This is a serious condition and requires care from your doctor.

  • Causes

    Wound dehiscence varies depending on the kind of surgery you have. The following is a list of generalized causes:

    • Infection at the wound
    • Pressure on sutures
    • Sutures too tight
    • Injury to the wound area
    • Weak tissue or muscle at the wound area
    • Incorrect suture technique used to close operative area
    • Poor closure technique at the time of surgery
    • Use of high-dose or long-term corticosteroids

    • Severe vitamin C deficiency (
      scurvy
      )
    Wound Infection
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  • Definition

    Wound dehiscence is the parting of the layers of a surgical wound. Either the surface layers separate or the whole wound splits open. This is a serious condition and requires care from your doctor.

  • Diagnosis

    Your doctor will ask about your symptoms and examine the surgical area. Tests may include the following:


    • Laboratory tests, such as:

      • Wound and tissue cultures to determine if there is an infection
      • Blood tests to determine if there is an infection

    • Imaging studies, such as:

      • X-ray
        —to evaluate the extent of wound separation
      • Ultrasound
        —to evaluate for pus and pockets of fluid
      • CT scan
        —to evaluate for pus and pockets of fluid

  • Prevention

    • When appropriate, have antibiotic therapy prior to surgery.
    • When appropriate, have antibiotic therapy after surgery.
    • When using wound dressing, maintain light pressure on wound.
    • Keep wound area clean.
    • Comply with post-operative instructions.

  • Risk Factors

    The following factors increase your chance of developing wound dehiscence.

    • Overweight
    • Increasing age
    • Poor nutrition
    • Diabetes
    • Smoking
    • Malignant growth
    • Presence of prior scar or radiation at the incision site
    • Non-compliance with post-operative instructions (such as early excessive exercise or lifting heavy objects)
    • Surgical error
    • Increased pressure within the abdomen due to: fluid accumulation (ascites); inflamed bowel; severe coughing, straining, or vomiting
    • Long-term use of corticosteroid medications

    • Other medical conditions, such as
      diabetes
      ,
      kidney disease
      ,
      cancer
      ,
      immune problems,
      chemotherapy
      , or
      radiation therapy

  • Symptoms

    If you experience one or more of these symptoms in the surgical area, contact your doctor.

    • Bleeding
    • Pain
    • Swelling
    • Redness
    • Fever
    • Broken sutures
    • Open wound

  • Treatment


    • Drug therapy

      • Antibiotic therapy

    • Medical treatment

      • When appropriate, frequent changes in wound dressing to prevent infection
      • When appropriate, wound exposure to air to accelerate healing and prevent infection, and allow growth of new tissue from below

    • Surgical intervention

      • Surgical removal of contaminated, dead tissue
      • Resuturing
      • Placement of a temporary or permanent piece of mesh to bridge the gap in the wound


    If you are diagnosed with wound dehiscence, follow your doctor's
    instructions
    .