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(Surgical Wound Dehiscence; Operative Wound Dehiscence)
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
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Factors that may increase your chance of wound dehiscence include:
- Being overweight
- 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, 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
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 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
- Remove contaminated and/or dead tissue
- Resuture the wound
- Place a temporary or permanent piece of mesh to bridge the gap in the wound
To help 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
American College of Surgeons
Centers for Disease Control and Prevention
Canadian Association of Wound Care
The Canadian Society of Plastic Surgeons
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—prevention. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T316886/Surgical-site-infection-prevention. Updated August 22, 2016. Accessed September 29, 2016.
- Reviewer: Donald Buck, MD
- Review Date: 09/2015
- Update Date: 09/30/2013