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

    Factors that may increase your chance of wound dehiscence include:

        
  • Being 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, which can occur with fluid accumulation ascites, inflamed bowel, 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

    Wound dehiscence may cause:

        
  • 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 tests, such as:

        
  • X-ray
  • Ultrasound
  • CT scan
  • Treatment

    Treatment may include:

        
  • Antibiotics if an infection is present or possible
  • 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—when appropriate
  • Surgery to:    
  • Remove contaminated and/or dead tissue
  • Resuture the wound
  • Place a temporary or permanent piece of mesh to bridge the gap in the wound
  • Prevention

    To reduce your chance of wound dehiscence:

        
  • 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