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.
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.
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.
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.
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.
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.
Alginate dressings can absorb up to 20 times their weight in wound fluid, which makes them effective for wounds with moderate to heavy exudate.
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.
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.
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.
The cut may need restitched (or glued) if gaping open. This is sometimes done if suturing was less than 48 hours ago.
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.
You should keep a wound moist and covered for about five days.
Foam dressings absorb exudates from the wound's surface, creating an environment that promotes faster healing. These dressings allow water vapour to enter, keeping the area moist, promoting faster healing, but prevent bacteria from entering the affected area.
The ideal dressing should keep the wound moist but not macerated, limit bacterial overgrowth, keep odor to a minimum, and be comfortable to wear. Frequent inspection of the wound is necessary to optimize wound dressing selection. Today there are many types of dressings and even techniques to manage wounds.
A wound that separates after surgery won't close neatly and will be weaker after healing. It is also at greater risk of becoming infected. In rare instances, a wound that doesn't close properly can result in evisceration , which occurs when internal organs (most often organs in the abdomen), push out through the wound.
These include antibiotics (penicillins, sulfa agents), anticoagulants, nicotine (via smoking), steroids, and drugs that decrease blood flow (eg, vasoconstrictors).
Glucocorticoids (corticosteroids) cause dehiscence of surgical incisions, increased risk of wound infection, and delayed healing of open wounds.
Dehiscence is secondary to technical failure of sutures, shear forces from tension, or fascial necrosis from infection and/or ischemia (2). Evisceration is the uncontrolled exteriorization of intraabdominal contents through the dehisced surgical wound outside of the abdominal cavity.
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.