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)

Risk Factors

The following factors increase your chances of developing wound dehiscence.

• Overweight

• High blood pressure

• Increasing age

• Poor nutrition

• Sex: female

• Diabetes

• Smoking

• Malignant growth

• Presence of prior scar at the incision site

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

• • Wound and tissue cultures to determine if there is an infection

• • Blood tests to determine if there is an infection

• Imaging Studies

• • 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

Prevention

• When appropriate, antibiotic therapy prior to surgery

• When appropriate, antibiotic therapy after surgery

• When using wound dressing, maintain light pressure on wound

• Keep wound area clean

RESOURCES:

American College of Surgeons
http://www.facs.org/

Merck Manual
MerckSource
http://www.mercksource.com

CANADIAN RESOURCES:

Canadian Association of Wound Care
http://www.cawc.net/open/wcc/index.html

References:

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.