Wound dehiscence: Difference between revisions
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'''Wound dehiscence''' is the premature "bursting" open of a [[wound]] along surgical suture. It is a surgical complication that results from poor wound healing. Risk factors are age, diabetes, obesity, poor knotting or grabbing of stitches, and trauma to the wound after surgery.<ref>[http://cancerweb.ncl.ac.uk/cgi-bin/omd?wound+dehiscence], "Definition of dehiscence: Cancer Web"</ref><ref>[http://www.upmc.com/HealthManagement/ManagingYourHealth/HealthReference/Diseases/?chunkiid=99918], "Definition of dehiscence: UPMC"</ref> Sometimes a pink (serosanguinous) fluid may leak out. |
'''Wound dehiscence''' is the premature "bursting" open of a [[wound]] along surgical suture. It is a surgical complication that results from poor wound healing. Risk factors are age, diabetes, obesity, poor knotting or grabbing of stitches, and trauma to the wound after surgery.<ref>[http://cancerweb.ncl.ac.uk/cgi-bin/omd?wound+dehiscence], "Definition of dehiscence: Cancer Web"</ref><ref>[http://www.upmc.com/HealthManagement/ManagingYourHealth/HealthReference/Diseases/?chunkiid=99918], "Definition of dehiscence: UPMC"</ref> Sometimes a pink (serosanguinous) fluid may leak out. |
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Furthermore, the size, location, and type of the wound impacts its probability of rupture. |
Furthermore, the size, location, and type of the wound impacts its probability of rupture. |
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==Treatment== |
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===Wound packing=== |
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One form of treatment for extensive dehiscence involves packing the wound with excess gauze, or other absorbents, and securing the packing with tape. This packing creates support for the muscles in the area, while assisting in cleaning out the wound by absorbing infectious drainage and tissue. |
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=== Vacuum therapy === |
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[[File:KCI Wound Vac02.jpg|thumb|185px|right|A brand of "wound vacuum" used for [[negative pressure wound therapy|NPWT]]]] |
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If the wound is larger, [[negative pressure wound therapy]] may be utilized. The wound is packed with an absorbent medium such as gauze, or a sponge, typically cut to fit the size and shape of the wound, then covered with an adhesive plastic air seal, through which a flexible tube is inserted. The tube is attached to a portable vacuum source and the wound is then put under negative pressure - usually around 100-150 [[mmHg]]. This procedure provides similar treatment as the traditional packing method does, in that it removes potentially infectious drainage and bacteria from the wound, just on a more automatic basis. When the vacuum is changed, the adhesive, sponge, and tubes are all replaced. |
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The wound packing may be replaced frequently (usually three times a week), or daily in some cases. This method takes several weeks to heal the wound. Depending on wound size, it can be used for a series of 2–4 weeks, or until the wound is shallow enough that the absorbent medium used wouldn't fit into the wound. From that point on, the traditional wound packing method would be used for the following weeks until the wound is fully healed. |
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== Notes == |
== Notes == |
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[[Category:Surgery]] |
[[Category:Surgery]] |
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Revision as of 17:34, 24 June 2011
 | This article needs additional citations for verification. |
Wound dehiscence is the premature "bursting" open of a wound along surgical suture. It is a surgical complication that results from poor wound healing. Risk factors are age, diabetes, obesity, poor knotting or grabbing of stitches, and trauma to the wound after surgery.[1][2] Sometimes a pink (serosanguinous) fluid may leak out.
A possible cause of wound dehiscence includes inadequate scar formation, which in turn can be caused by any of the following:
- Ehlers-Danlos syndrome. People with this genetic disorder are unable to make normal collagen, which is essential in scar formation.
- Scurvy. Scurvy is a disease caused by Vitamin C (ascorbic acid) deficiency. Vitamin C is required to create strong cross links between collagen fibers. An inability to make these cross links leads to weak scar tissue.
- Poor blood supply to the wound. Inflammation, and subsequent delivery of nutrients is vital for wound healing. Some individuals, such as diabetics, have poor blood supply in certain parts of their body.
- The use of medications. Medications such as anti-inflammatory agents such as steroids inhibit proper wound healing.
- Physical stress. Often, wound dehiscence occurs from physical stress on the wound. Physical stress can be caused by the Valsalva maneuver or by other physical forces, such as by flexure of a nearby joint.
- Bacterial weakening of the tissue.
Furthermore, the size, location, and type of the wound impacts its probability of rupture.
Notes
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