A dehisced wound can appear fully open – the tissue underneath is visible – or it can be partial, where just the top portion of the skin has torn open. The wound could be red around the wound margins, have drainage, or it could be bleeding or seeping, where only a thin trickle of blood is coming out.
Symptoms of wound dehiscence
Pain. Feeling of pulling or ripping like something popped. Drainage or bleeding from the wound, most often a clear to pink fluid. Signs of wound infection such as fever, redness, swelling, bad smelling discharge, or chills.
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.
Deep dehiscence of the underlying fascia is a surgical emergency and must be closed in the operating room, as this can lead to evisceration. If the wound shows signs of evisceration, the wound can be covered with a sterile saline dressing until the herniating organs can be reduced back into the abdomen.
The patient should be advised the wound will heal by secondary intention as a result of the dehiscence and that this can take several weeks. More extensive wound dehiscence may require negative pressure wound therapy to aid in healing.
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.
Closure. 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. If you notice any of these symptoms, contact your doctor immediately.
If associated with superficial wound dehiscence, they can be treated by absorbent dressings such as alginate dressing.
Although rates of dehiscence are low, once it occurs, the possibility of further complications or death is high. 7 Thus, any break in a post-surgical incision should be reported to your surgeon at once, before it becomes a potentially life-threatening medical emergency.
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.
A dehisced wound can appear fully open – the tissue underneath is visible – or it can be partial, where just the top portion of the skin has torn open. The wound could be red around the wound margins, have drainage, or it could be bleeding or seeping, where only a thin trickle of blood is coming out.
Wound dehiscence is estimated to occur in 0.5–3.4% of abdominopelvic surgeries, and carries a mortality of up to 40%.
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.
The cut may need restitched (or glued) if gaping open. This is sometimes done if suturing was less than 48 hours ago.
Dehiscence and evisceration can be a life threatening emergency; do not leave the client immediately call for help and, using a clean, sterile towel or sterile saline dampened dressing, cover the wound. Under no circumstance should reinserting the organs be attempted.
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.
On the scene. To decrease intra-abdominal pressure and stress on the wound, you place Mr. Anderson supine in the low Fowler's position with his knees slightly bent and cover the wound with a saline-moistened, sterile gauze dressing.
You should keep a wound moist and covered for about five days.
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.
Do keep the cut or scrape covered with a bandage to keep it moist and prevent it from reopening for faster healing. Change the bandage daily — or sooner if it becomes dirty or wet — to keep the wound clean.
Wounds need to be covered so that they can heal properly. When a wound is left uncovered, the new surface cells that are being created can easily dry out. When these important cells dry out, it tends to slow down the healing process. A wound should be covered using a clean bandage.
Wounds generally heal in 4 to 6 weeks. Chronic wounds are those that fail to heal within this timeframe. Many factors can lead to impaired healing. The primary factors are hypoxia, bacterial colonization, ischemia, reperfusion injury, altered cellular response, and collagen synthesis defects.
It's common to have small amounts of fluid drain or ooze from a scrape. This oozing usually clears up gradually and stops within 4 days. Drainage is not a concern as long as there are no signs of infection.