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Wound Dehiscence. Dr. Neeraj Kumar Jain. 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. . Causes.
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Wound Dehiscence • Dr. Neeraj Kumar Jain
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.
Causes • Wound dehiscence varies depending on the kind of surgery . 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
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 , radiation therapy
Symptoms • Pain • Swelling • Redness • Fever • Bleeding • Broken sutures • Open wound
Diagnosis • 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 • Placement of a temporary or permanent piece of mesh to bridge the gap in the wound
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.
