(Surgical Wound Dehiscence; Operative Wound Dehiscence)
Pronounced: dē-his’ ens
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.
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)
The following factors increase your chance of developing wound dehiscence.
- Increasing age
- Poor nutrition
- 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]]> , ]]>radiation therapy]]>
If you experience one or more of these symptoms in the surgical area, contact your doctor.
- Broken sutures
- Open wound
Your doctor will ask about your symptoms and examine the surgical area. Tests may include the following:
- Wound and tissue cultures to determine if there is an infection
- Blood tests to determine if there is an infection
- Imaging Studies
- Antibiotic therapy
- 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 removal of contaminated, dead tissue
- 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 .
American Academy of Family Physicians
American College of Surgeons
Canadian Association of Wound Care
The Canadian Society of Plastic Surgeons
Barbul A. Wound Healing. In: Schwartz’s Principles of Surgery . 8th ed. 2005. Online Version. Available at: http://80=pm;ome=statref=cp,/;obraru/tifts/ediDpci,emt/as[xDpdd=205&Fxld=18&sessionID=5353EOZYOOBHJVKV&Scroll=1Index=6 . Accessed September 27, 2005.
Bennett R. Fundamentals of Cutaneous Surgery . CV Mosby Co: St. Louis, MO; 1988:498.
Current Obstetric & Gynecologic Diagnosis & Treatment . 9th ed. 2003. Online edition. Available at: http://80-online-statref-com.library.tufts.edu/Document.aspx?Dodd-550&Fxld-30&sessionID=5353EOZYOOBHJVKV&Scroll=1&Index=4 . Accessed September 20, 2005.
Dorland's Illustrated Medical Dictionary. WB Saunders, Harcourt Health Sciences; 2005. Online edition. Available at: http://www.merckmedicus.com/pp/us/hcp/thcp_dorlands_content.jsp?pg=/ppdocs/us/common/dorlands/dorland/dmd-d-005.htm . Accessed September 20, 2005.
Surgery. Merck Manual–2nd Home Edition. 2004. Available at: http://www.mercksource.com/pp/us/cns/cns_search_results.jsp . Accessed September 27, 2005.
Last reviewed November 2008 by ]]>Rosalyn Carson-DeWitt, MD]]>
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