Wound Dehiscence

(Surgical Wound Dehiscence; Operative Wound Dehiscence)

Definition

Wound dehiscence is the separation of the edges of a surgical wound. It may be just the surface layer or the whole wound. It may become a serious problem. See your doctor if a wound has split open.

Causes    TOP

The cause may vary depending on the type of surgery. Some general causes include:

  • Infection at the wound
  • Pressure on sutures
  • Sutures are too tight
  • New injury to the area
  • Weak tissue or muscle at the wound area
  • Incorrect suturing at time of surgery
  • Use of high-dose or long-term corticosteroids

Wound Infection

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Risk Factors    TOP

Factors that may increase your chance of wound dehiscence include:

  • Being overweight
  • Increasing age
  • Poor nutrition
  • Diabetes
  • Smoking
  • Cancer at the site
  • Having a scar or previous radiation at the site
  • Not following instruction for care after surgery (such as too much exercise too early or exercise or lifting heavy objects)
  • Increased pressure within the belly—can happen with fluid build up, inflammation, or 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    TOP

Wound dehiscence may cause:

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

Diagnosis    TOP

The surgeon will examine the wound. If there are signs of an infection the following may be done:

  • Sample of fluids from the wound will be tested for infection
  • Blood tests—for signs that the body is fighting an infection

Further test may only be needed if the wound is deep or not healing well. The surgeon may want to see how much tissue is affected. This can be done with:

Treatment    TOP

Treatment may include:

  • Antibiotics if an infection is present or possible
  • Changing wound dressing often to prevent infection
  • Open would to air—will speed up healing, prevent infection, and allow growth of new tissue from below
  • Negative pressure wound therapy—a dressing that is to a pump that can speed healing
  • Surgery for one or more of the following:
    • Remove damaged. infected, and/or dead tissue
    • Put new sutures in the wound
    • Place a piece of mesh to help close the wound

Prevention    TOP

To help reduce your chance of wound dehiscence:

  • Follow you care team's instructions which may include:
    • Antibiotics before surgery
    • Antibiotics after surgery
  • Keep light pressure on the wound when applying dressing
  • Keep wound area clean
  • Carefully follow any instructions from your care team

RESOURCES:

American College of Surgeons
https://www.facs.org
Centers for Disease Control
https://www.cdc.gov

CANADIAN RESOURCES:

Canadian Society of Plastic Surgeons
http://plasticsurgery.ca

References:

Sandy-Hodgetts K, Carville K, Leslie GD. Determining risk factors for surgical wound dehiscence: a literature review. Int Wound J. 2015 Jun;12(3):265-75.
Surgical site infection—prevention. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated September 13, 2018. Accessed December 19, 2018.
Last reviewed September 2018 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 12/19/2018

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