Preventing Surgical Wound Dehiscence It is essential to practice good hygiene, keep the wound clean, dry, and intact, and follow the provider's specific instructions on wound care and any prescribed medications.
The causes of dehiscence are similar to the causes of poor wound healing and include ischemia, infection, increased abdominal pressure, diabetes, malnutrition, smoking, and obesity. [1] Superficial dehiscence is when the wound edges begin to separate and by increased bleeding or drainage at the site.
Hyperbaric Oxygen Therapy can help reduce the potential complications of wound dehiscence. Hyperbaric wound care is a safe, natural, and efficient medical therapy for wounds that may need additional support to properly heal. It uses 100% oxygen to stimulate accelerated healing capabilities within the body.
Preventive measures to avoid wound dehiscence and wound evisceration include client coaching and teaching the client how to splint their incisional area when coughing, sneezing, vomiting and when doing planned, routine coughing and deep breathing exercises post operatively.
What Are Risk Factors for Dehiscence? A variety of underlying health conditions can increase a patient's risk for developing dehiscence after surgery. Such conditions include the patient being overweight or obese, hypertension, anemia, and hypoproteinemia.
Wound dehiscence is caused by many things such as age, diabetes, infection, obesity, smoking, and inadequate nutrition. Activities like straining, lifting, laughing, coughing, and sneezing can create increased pressure to wounds, causing them to split.
Even minor cases of wound dehiscence require immediate attention to prevent the wound from worsening. If left untreated, dehiscence can progress and lead to serious infection and life threatening complications.
Nursing management The patient should be put to bed immediately and complete bedrest is advised. Assessment of the degree of dehiscence and evisceration can now be made. Other nursing actions are as follows: in warm saline. Exposed viscera should be protected from drying and possible necrosis.
Early signs of wound dehiscence
If associated with superficial wound dehiscence, they can be treated by absorbent dressings such as alginate dressing.
A superficial wound dehiscence can typically be treated with conservative measures only. Any underlying cause (e.g. SSI) should be managed accordingly. Simple wound care is all that is required in the majority of cases, with regular wound packing and cleaning with sterile saline.
The doctor may close the wound separation with new stitches, or they may allow it to heal as it is. If a wound disruption is deep or complete, you may need another surgery to repair the wound.
Treatment for wound dehiscence depends of how large the opening is, whether there is infection, how soon the incision opened after the surgery, and whether you have other conditions that make it harder for the wound to heal. This might include diabetes, smoking, and poor nutrition. Treatment includes: Pain medicine.
Wound dehiscence is estimated to occur in 0.5–3.4% of abdominopelvic surgeries, and carries a mortality of up to 40%.
Abdominal wound dehiscence (burst abdomen, fascial dehiscence) is a severe postoperative complication, with mortality rates reported as high as 45% [1–3]. The incidence, as described in the literature, ranges from 0.4% to 3.5% [4–17]. Abdominal wound dehiscence can result in evisceration, requiring immediate treatment.
Apply a bandage, rolled gauze or gauze held in place with paper tape. Covering the wound keeps it clean. If the injury is just a minor scrape or scratch, leave it uncovered.
Purulent drainage: Purulent drainage, the thickest of the three types, is white, yellow or brown fluid. It indicates that bacteria entered your wound and caused an infection. Infections can be harmful to your body, so this fluid needs treatment.
The cut may need restitched (or glued) if gaping open. This is sometimes done if suturing was less than 48 hours ago.
Risk factors for dehiscence and evisceration include age, diabetes, obesity, malnutrition, corticosteroid therapy, and sepsis. Wound infection is directly associated with over 50% of eviscerations [1]. Surgical technique can contribute to wound dehiscence.
A skin wound that doesn't heal, heals slowly or heals but tends to recur is known as a chronic wound. Some of the many causes of chronic (ongoing) skin wounds can include trauma, burns, skin cancers, infection or underlying medical conditions such as diabetes. Wounds that take a long time to heal need special care.
Treatments for Wound Dehiscence
Surgical debridement is typically performed to treat wound dehiscence by removing the dead or infected tissue to enable better healing of the wound. Next the wound must be closed properly with the appropriate surgical technique and sutures.
You should keep a wound moist and covered for about five days.
A non-healing surgical wound can occur after surgery when a wound caused by an incision doesn't heal as expected. This is usually caused by infection – a rare but serious complication. Causes of poor wound-healing depend on the type and location of the procedure, health condition and other factors.