Wound Dehiscence Infection

Wound dehiscence is sometimes called wound breakdown, wound disruption, or wound separation. It happens when a cut made by a surgeon separates at the edges and the wound reopens. Like other types of poor wound healing, the causes of this separation include infection, increased pressure on the abdomen (for example, from heavy lifting or a severe cough), diabetes, poor diet, smoking, and obesity. Specific factors that can put you at risk for dehiscence include wound infection, vitamin deficiency, cancer, and steroid use.

Although it can happen at any time during the healing process, wound dehiscence typically happens in the early stages, usually four to nine days after surgery – and most commonly on the seventh day. A small area of the skin that has been cut may come apart or the incision may separate completely through all the layers of skin and muscle.

When you see that an incision has separated, it’s important to determine the extent of the problem. With superficial dehiscence, only the upper layers of skin have separated. You can apply a type of fitted cloth belt called an “abdominal binder” to this kind of superficial wound to reduce strain on the wound, prevent infection, and keep the cut from separating further. Deep dehiscence of the underlying muscle is a surgical emergency. The wound must be closed by a surgeon to prevent the organs of the abdomen showing or poking through the gap in the incision (a condition called “evisceration”). If the wound shows signs of evisceration, you can cover it with a sterile saline dressing until you can get to an emergency room.

Medical specialties treating a wound dehiscence infection

Prompt identification is important to prevent complications. Treatment can involve a wound care nurse, general or vascular surgeon, hyperbaric specialist, infectious disease consultant, dietitian, and physical therapist. Be sure to have a team of wound experts regularly assess the wound in order for it to heal successfully.

How a wound dehiscence infection is treated

Your specialist will investigate the wound for signs of possible complications, including infection. The first step is to determine the reason the incision separated in order to ensure that the wound will heal. The second step is to make sure that the wound is clean, has ample blood supply, and is regularly debrided (scraped) to remove dead tissue. When an infection is present, the MicroGenDX test will indicate options for antibiotics or antifungals your specialist can prescribe to treat the infection in the “antimicrobials for consideration” section of the test results.

References

  1. WebMD website, “What Is Wound Dehiscence?” Accessed 16 May 2022 from: https://www.webmd.com/a-to-z-guides/what-is-wound-dehiscence
  2. Nagle SM, Waheed A, Wilbraham SC. Wound Assessment. [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482198
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