A surgical complication in which a closed surgical incision opens after surgery, exposing internal tissues or organs (sometimes), is called wound dehiscence. The most common symptoms of this complication include pain, bleeding, and broken stitches or sutures. Usually, it occurs when the wound does not heal properly. In some cases, doctors call this condition wound disruption or wound separation.
Some people may wonder why it happened and what a wound dehiscence means for their recovery. In general, there are several options that may lead to this condition. For example, stress on the incision, infections, and other diseases. While it can be scary when a cut opens, doctors have multiple options to manage the wound and get you back to recovery.
Types of Wound Dehiscence
There are two types of this condition. For example:
- Partial wound dehiscence – In such cases, a small part of the wound reopens. Sometimes, it may happen when the skin’s surface (epidermis) and the next layer (dermis) separate.
- Complete wound dehiscence – This type of condition occurs when the wound reopens completely. It means the whole incision opens, or it opens through all layers of the skin and muscle.
Symptoms
People usually experience different symptoms because it depends on some factors. These include the type and severity of the condition, age, existing health problems, and others. Check below some wound dehiscence symptoms:
- Pain
- Fever
- Swelling around the cut (incision)
- Red or dark skin color around the surgery site
- Broken sutures
- Bleeding
- A feeling that something is pulling or ripping in the incision
If you notice any of the previous symptoms, especially after surgery, immediately contact your healthcare professional.
However, the healing process is complex and often takes time. This condition may occur at any time during healing. Usually, most people do not notice the first steps in this process. In some cases, these steps are called the wound healing phases. Examples include:
- Hemostasis – This is a part of the body’s reaction to an injury (such as a cut). It starts to reduce bleeding and make a blood clot at the incision. Usually, this phase takes approximately 2 days to complete.
- Inflammation – It often occurs after a blood clot closes the cut. Thereafter, the blood vessels become larger to remove debris and bacteria.
- Proliferation – In this phase, the body is building new cells to create new tissue (also known as granulation tissue). Usually, during this period, you may notice bumpy pink or reddish skin. This phase often lasts up to 3 weeks.
- Maturation – During this phase, which may last up to one year, the tissue recovers strength and elasticity while the incision continues to heal.
Causes
One of the most common causes of a wound dehiscence is a surgical wound infection. It often occurs when you have a cut in the skin that allows bacteria to enter the body. Usually, the bacteria enter the body during surgery, recovery in the hospital, or recovery at home. Sometimes, people may experience some post-surgery complications (including severe vomiting or coughing) that may also lead to a wound dehiscence.
Risk Factors
Healthcare professionals have identified some factors that could increase your risk of developing a wound dehiscence. Check below some of them:
- Anemia – This condition causes reduced levels of oxygen-rich red blood cells. As a result, it may slow down the healing process.
- COPD – This disorder negatively affects the amount of oxygen in the blood. As a result, the cut does not heal.
- Diabetes – Those who suffer from this condition usually have high blood sugar levels. It negatively affects white blood cells involved in the healing of a wound.
- Hypoproteinemia – In people who experience this disorder, the protein levels in the blood are low. However, the body requires protein to repair and make new tissue and skin. That’s why it is hard for the body to produce new tissue in people with hypoproteinemia.
- Obesity – According to some studies, excessive body weight causes certain chemical changes in the body that impact the healing process.
However, there are some treatments that significantly increase the risk of a wound dehiscence. For example:
- Emergency surgery for a traumatic injury or sudden serious medical problems
- Radiation therapy – This is a cancer treatment used to destroy cancerous cells. However, it may cause scar tissue that negatively affects the healing process.
- Corticosteroids – This group of medicines is prescribed primarily to reduce inflammation in the body. It may affect the body’s ability to make new tissue and blood vessels. However, it is a risk factor for a wound dehiscence if corticosteroids are used for long periods.
What Are The Potential Complications of Wound Dehiscence?
Those who develop this condition may also experience some complications, especially if they ignore the symptoms and do not manage them. Check below some examples:
- Evisceration – This is one of the most dangerous complications of a wound dehiscence. It causes the internal organs to poke through the cut. In general, this is a medical emergency, and if it occurs, go to the nearest emergency room (ER) or call 911 right away.
- An increased risk of infections
- Delayed healing
- Increased scarring
- Prolonged hospitalization
- Mental health problems
This article does not contain a complete list of wound dehiscence complications. In any case, you can consult with your doctor about ways to reduce the risk of complications of this condition.
How to Prevent Wound Dehiscence?
While it is not possible to prevent all factors that could cause a wound dehiscence, you can take some steps to reduce the risk. For example:
- Adopt a healthy diet – These include fresh fruits, vegetables, whole grains, protein, and others.
- Stop smoking – Using tobacco products may reduce oxygen levels in the blood. If you are facing problems with smoking cessation, discuss it with your healthcare professional.
- Manage the incision – Doctors can explain how to care for a cut.
- Get plenty of rest – To improve the healing process, you need plenty of rest and liquids. Avoid lifting heavy objects or performing strenuous activities.
Diagnosis
Doctors usually diagnose this condition during a physical examination. In some cases, they can take a sample of fluid from the incision for testing and perform a CT (computed tomography) scan to check for bacteria and other health problems.
Treatment
Check below some treatments often recommended for people who develop a wound dehiscence:
- Intravenous (IV) antibiotics – These medicines are used to treat or prevent bacterial infections.
- Negative pressure wound therapy – During this treatment, the bandage on the wound is connected to a pump to drain fluid from the wound.
- Surgery – Physicians may perform another surgery to remove damaged, infected, or dead tissue.
Frequently Asked Questions
Will a dehiscence wound heal on its own?
In some cases, this condition may go away on its own, but it varies among individuals. Some people may need additional treatment to ease the symptoms or replace broken sutures.
How long does a dehiscence wound take to heal?
However, the healing process is complex, and it occurs differently among people. Generally, it takes a few weeks to heal, but some people may heal within several months.
When should I see my healthcare provider?
It is recommended to see a doctor if you notice that the incision reopens right after surgery. Ask your physicians if you have any other questions.
