Wound Dehiscence

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

The following factors increase your chance of developing wound dehiscence.

• 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 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 , or radiation therapy

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, such as:
  • Wound and tissue cultures to determine if there is an infection
  • Blood tests to determine if there is an infection
• Imaging studies, such as:
  • 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
  • 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 .

Prevention

• 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.

Revision Information

• Reviewer: Marcin Chwistek, MD
• Review Date: 09/2012 -
• Update Date: 09/27/2012 -