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.

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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    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
  • 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
  • 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 .

    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.