Wound dehiscence is a surgical complication where a surgical or traumatic wound reopens after it has been stitched or closed, consequently exposing internal tissues and possibly organs. Nevertheless, this condition can be scary and quite painful but with proper care and knowledge, most cases can be managed effectively.
In this blog, we’ll explain what wound dehiscence is, why it happens, treatment options, and most importantly, what you can do to prevent it.
What Is Wound Dehiscence?
A wound dehiscence is a medical condition in which a previously closed incision (cut) or different types of wounds separate or break open, either partially or completely. You can imagine it like a zipper that suddenly splits open in the middle.
It usually happens within 7 to 10 days after surgery when the body is still healing. It is most common after surgical procedures, especially abdominal surgeries, and might require post-surgical wound care. Doctors may also call this condition wound separation or wound disruption.
Types Of Wound Dehiscence
There are two main types of wound dehiscence:
Partial dehiscence – This means that only a small section of the wound has been opened. Often, it affects just the top layers of the skin, such as the outer layer (epidermis) and the layer right below it (dermis).
Complete dehiscence – In this case, the whole wound reopens. It may involve not just the skin but also deeper layers, including muscle, depending on how severe it is.
Despite being serious and frightening, wound dehiscence can still be managed. The healthcare providers know how to treat this condition. Moreover, there are specialized wound centers that provide advanced wound care and thus help your body heal. So, with the right care, most people recover and get back on track.
Symptoms Of Wound Dehiscence
The following are some common, early signs of wound dehiscence:
- Pain or discomfort at the wound site.
- Wound edges are pulling apart.
- Bleeding or fluid discharge from the site.
- Redness or swelling, particularly at the wound site.
- Visible tissue or sutures under the skin.
Note: If you observe any of these signs, consult a healthcare provider immediately.
Causes And Risk Factors
Meanwhile, wound dehiscence, or surgical wound separation, can happen for several reasons. The most common cause is bacterial infection. It can happen anytime, either during surgery, soon after, or while recovering at home and eventually disrupts the healing process.
Besides infection, other common causes include:
- Weak sutures that don’t hold the wound closed properly.
- Excessive movement or strain on the incision site.
- Post-surgery complications like heavy coughing or vomiting, which can put pressure on the wound and cause it to reopen.
Certain risk factors can also increase the chances of a wound reopening:
Obesity: Extra body fat puts pressure on the wound and reduces blood flow, slowing healing and raising the risk of wound separation.
Anemia: A lack of healthy red blood cells means less oxygen is delivered to the wound, which delays the healing process.
Diabetes: High blood sugar affects how white blood cells work, thus weakening the immune system and slowing down the healing process.
COPD (Chronic Obstructive Pulmonary Disease): This lung condition lowers the oxygen level in your blood, which can make wound healing slower and less effective.
Malnutrition or low protein levels: Your body needs enough protein and nutrients to repair tissues. So, without them, healing takes longer.
Smoking: Smoking decreases oxygen supply to the wound and weakens the body’s ability to heal properly.
Radiation therapy: Cancer treatment with radiation can leave behind scar tissue, which can block normal healing around the incision.
Steroids or immunosuppressive medications: These drugs can slow down the healing process by weakening the body’s natural tissue repair system.
Dehiscence Wound Healing Stages
Wound healing is a natural but complex process. When dehiscence occurs, the wound may have to go back to earlier healing stages:
Hemostasis (Immediate):
The body stops bleeding by forming clots. This is the very first response when the skin is broken.
Inflammation (1–3 Days):
Immune cells rush to the wound to destroy bacteria and clean out dead cells. Swelling, warmth, and mild redness are normal during this stage.
Proliferation (4–21 Days):
New tissue (granulation tissue) and blood vessels form. As a result, skin begins to regrow, and the wound starts to shrink in size.
Maturation (Up to a Year):
Collagen strengthens the wound, and a scar forms. Over time, the scar becomes smoother, stronger, and less noticeable.
If a wound reopens, it may cycle back to the inflammation or proliferation stage, which can delay overall healing.
For more info, read What to Know About Types of Wound Healing?
Wound Dehiscence Treatment Options
Treatment depends on how severe the wound separation is:
1. Mild Cases (Partial Separation):
- Keep the wound clean and dry.
- Apply antibiotic ointments as directed.
- Use wound dressings that promote healing (hydrocolloid or foam).
- Follow up regularly with your healthcare provider.
2. Moderate to Severe Cases:
- Surgical revision or re-suturing may be required.
- Debridement (removal of dead tissue) to promote fresh healing.
- Antibiotics to treat or prevent infection.
- Negative Pressure Wound Therapy (NPWT) for larger or complex wounds.
Wound Dehiscence Treatment At Home
Since home care is crucial in mild cases or post-hospital treatment. Here’s what you can do:
- Change dressings as instructed, using sterile materials.
- Avoid straining or lifting that puts pressure on the wound.
- Maintain a high-protein diet to support tissue repair.
- Monitor for signs of infection.
- Avoid smoking and alcohol, which slow healing.
Note: Do not attempt to close the wound yourself. Always consult a medical professional.
Final Thoughts
In conclusion, wound dehiscence can be worrying. But with the right care, most people recover fully. Understanding the healing stages, knowing the risk factors, and learning about treatment options can help you stay in control and prevent further problems. So, if you notice signs of infection or if the wound worsens, contact your doctor right away.
Also, for more advanced care, you can consider visiting the Amniotic Wound Center, which offers the latest treatments.
Remember, staying alert and informed is the best way to support healing. Therefore, don’t delay and get medical help when needed.
