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Wound Dehiscence: Causes, Treatment & Prevention

wound dehiscence, evisceration
Written by healthphreaks

What Is Wound Dehiscence?

Wound dehiscence also is known as “wound separation” is a condition when a surgical incision reopens either partially or perhaps completely along the sutures. This means the wound reopens, thereby creating a new wound.

Also, it is a condition where a cut (incision) that was made during a surgery splits or separates after it has been stitched back together. The split can happen in the entire wound or just in the skin layers.

Wound Dehiscence can be upsetting; however, it commonly occured among people who have received sutures. Also, it is commonly associated with surgical site infection.

Although this condition can take place after any surgery, often it happens within 2 weeks of surgery (operation). This can be as a result of early stitch removal, infections, incorrect suture technique, injuries, weak tissue in the region of the wound, Excessive vomiting, or coughing.

Often, Wound Dehiscence usually happens with abdominal surgeries like C-sections and Laparotomies. It is crucial to monitor the healing process of your wound, as any form of openings can result in an infection. However, if not treated, a more severe form of this condition can occur known as wound evisceration.

wound dehiscence, evisceration

c-section: wound dehiscence

Wound evisceration this is a condition in which your wound reopens, and your internal organs stick out through the incision; this could be a deadly condition.

A person with wound dehiscence might have the following symptoms;

  • broken sutures,
  • bleeding in the area,
  • pain,
  • fever,
  • swelling in the region,
  • redness, and a visibly open injury.

What Are The Causes of Dehiscence After Surgery?

Wound dehiscence is always a risk. It can be done accidentally or intentionally; everyone is at risk of having dehiscence no matter how fit and healthy the individual can be. The amount of physical activity that affects the wound area, the patient’s health, the location of the wound all can increase or decrease the chances of this condition.

The following risk factors for wound dehiscence are as follow:

  1. Strain from vomiting, coughing, or sneezing
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When there is too much pressure or force in the abdominal area where the surgery occured, it can cause the wound to reopen. Excessive pressure or pulling can cause the 2 sides of the injury to separate and have the stitches broken.

  1. Infection

Wounds that have an infection will take longer time to heal, which makes a person more prone to having dehiscence. The infection can delay the healing process of a wound and thereby extending the time where the incision is at risk of injury.

  1. Underlying health condition.

Underlying health conditions such as Diabetes and AIDS affect the immune system, and this can impair the healing ability; then increases the chances of wound dehiscence.

  1. Surgeon inexperience or mistake

If your surgeon has applied the sutures wrongly or not properly done; this can lead to your wounds reopening and thereby leading to this condition.

  1. Obesity

People with weight problems are most likely to have issues with wound closure and healing. Obesity tends to slow down the healing process because fat cells in their body have fewer blood vessels to enable them to transport oxygen around their body.

  1. Malnutrition

An individual who is malnourished or lacks proper diet may not be able to have their wounds healed quickly. Due to the lack of proteins and vitamins needed for a swift recovery.

  1. Smoking

Since smoking can reduce oxygenation in tissues necessary for fast recovery; it can lead to this condition

  1. Re-exploration

A surgery that requires a surgeon to go back into a previously operated spot can also lead to further unexpected complications, such as reopening of an original wound which can lead to this condition

 Also Read: Trench Mouth: Causes, Symptoms & Treatment

How To Tell If A Wound Is Dehisced?

If an incision separates or splits following surgery, the wound is said to be “dehisced. A dehisced wound can either appear fully or partially opened. The wound could be seeping or bleeding, have drainage where only a thin drip of blood is coming out.

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The would will also be painful, and as time goes on will increase in pain. People need to be aware that even if a wound appears like it’s healing, if any stitches are broken; this could be a sign that it is about to dehisce.

wound dehiscence, evisceration

reopened wound leading to dehiscence

How to Treat a Dehisced Wound

The treatment for a dehisced wound is much-like to the treatment for a new wound. There are certain things that needed to be done like if there’s an infection, it must be treated with anttibiotics.

According to research, the average time for an incision in the abdominal region to fully recover and heal is about 2 months. So, if you find out that your wound is reopening, Please consult your surgeon or doctor right away.

The treatment of this condition can either involve medicines to combat the pains and fight infections and surgery to remove dead tissue (possibly debrided) and repair the wound.

How do I prevent dehiscence?

To prevent wound dehiscence, the impacted person must follow all post-suture instructions carefully, especially any post-suture instructions regarding when the wound spot can get moist or wet.

Some of the best ways to prevent this condition are:

  1. Avoid lifting: Within the first 2 weeks after surgery do not lift anything heavier than 5 pounds as this can may increase the pressure on the incision that can cause it to open. Avoid lifting heavy substances until your wound fully recovers.
  2. When you are doing any activity that can increase abdominal pressure hold pressure over your cut, making use of a pillow or your hands. This will help reduce pain during activity and prevent dehiscence. Please, it is vital for patients to follow doctor’s instruction carefully and reduce activities which can impact the wound area.
  3. Patients should report any new pain or redness or perhaps pain that doesn’t seem to go to their doctor so that the doctor can examine if the wound is properly healing.
  4. You must move carefully and protect the wound region from anything that can cause friction or perhaps pull the around the wound area.
  5. Minimize coughing and sneezing. If you just had a surgery avoid heavy coughing or sneezing. Excessive coughing and sneezing can place more stress on your incision which can slow the healing process and then can lead to dehiscence.
  6. Clean your wound and change your bandage as directed. If you doctor ask you to clean the area around the wound please do and change bandage also to avoid infections. Change bandage when they are dirty and wet.
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When Should I Contact My Doctor?

  • ·     You have a fever
  • ·     You see tissue coming through your wound.
  • ·     You feel like your wound is reopening
  • ·     Your pain gets worse
  • ·     Some amount of blood or fluid leaks from your wound

If wound dehiscence isn’t properly treated can become life-threatening. To avoid this condition, please the patients should keep the wound area clean and follow all your doctor’s post-suture instructions.

Also, if you are experiencing evisceration; the severe form of Dehiscence, please don’t try to push back the organs yourself inside your body. Seek emergency medical attention immediately.

Also Read:

Article Soure

Sandy-Hodgetts K, et al. (2013). Determining risk factors for surgical wound dehiscence: a literature review. DOI:
10.1111/iwj.12088

Getting life back to normal after surgery. (2018).
healthcare.utah.edu/the-scope/shows.php?shows=0_jcd5tg17

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healthphreaks

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