What Causes Wound Dehiscence?

Wound dehiscence is a medical term that defines a wound that fails to heal or one that opens along its incision line following surgery. Such complications are often seen following abdominal surgery and can be caused by several factors. Understanding the causes of wound dehiscence and taking steps to prevent it may lead to enhanced outcomes and reduction of infection in patients and those healing from surgery, wound care and injuries both in hospital locations and at home.

Definition

• Wound dehiscence typically involves failure of a surgical wound to remain closed after suturing, or may define a wound that fails to heal. In most cases, systemic and manual factors can lead to this condition. Regardless of what causes wound dehiscence, the results range from a patient having to go back into surgery, to site and systemic infections, increasing wound size, hematomas (blood clots) and unsightly scars.

Causes

• Early suture removal is often one of the main causes of wound dehiscence. Sutures may close superficial wounds but often don't provide deep muscle support and closure of healing wounds when removed too early. Usually sutures are removed only after edges of a healing wound appear pink and slightly raised and not before. In other cases, a history of smoking or certain medications may slow the healing process and encourage dehiscence for many patients.

Prevention/Solution

• Wound dehiscence may be prevented by ensuring adequate time has passed before sutures are removed. In addition, health care providers are advised and cautioned to watch for signs that a wound might not be healing properly, such as serosanguineous (bloody peritoneal fluid) from wounds, pain and vomiting, or complaints by patients that they have felt something tearing. Careful monitoring of patients recovering from surgical procedures or wound injuries based on age, type of wound and location.

Ongoing Care

• Patients who have been discharged from health care facilities must be cautioned regarding physical activity and diet following any type of surgical procedure. Detailed instructions should be offered upon discharge as well as instruction for self-care of wound site at home.

Risks

• Risks of experiencing wound dehiscence increase due to surgical error, such as widely spaced sutures or sutures placed too close to the incision or wound or sutures that are too tight. Risks of wounds splitting or tearing sutures also occurs in patients who cough violently, experience bouts of vomiting or has to strain for bowel movements.