Wound Dehiscence
En Español (Spanish Version)

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

Copyright © Nucleus Medical Media, Inc.
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:

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



RESOURCES:
American College of Surgeons

Centers for Disease Control and Prevention

CANADIAN RESOURCES:
Canadian Association of Wound Care

The Canadian Society of Plastic Surgeons

References:
Bennett R. Fundamentals of Cutaneous Surgery. St. Louis, MO: CV Mosby; 1988: 498.

DeCherney AH, Nathan L. Current Obstetric & Gynecologic Diagnosis & Treatment. 9th ed. New York, NY: McGraw-Hill; 2003.

Dorland WN. Dorland's Illustrated Medical Dictionary. Philadelphia, PA: WB Saunders, Harcourt Health Sciences; 2005.

Porter RS. The Merck Manual of Medical Information Home Edition. 2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2004.

Schwartz S, Brunicardi F, et al. Schwartz’s Principles of Surgery. 8th ed. New York, NY: McGraw-Hill; 2007.

Surgical site infection. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 14, 2014. Accessed September 30, 2014.

Surgical site infection—prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 29, 2014. Accessed September 30, 2014.

Last Reviewed August 2014



Health Information Library content is provided by EBSCO Publishing, fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

 

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

 

To send comments or feedback to EBSCO's Editorial Team regarding the content please e-mail healthlibrarysupport@ebscohost.com.